Hand hygiene - simplicity is the key to compliance

Paul Jakeway, marketing director of Deb, explains why the best way to improve hand hygiene compliance is to make each hand hygiene moment easy

As the threat of antimicrobial resistance (AMR) grows, hand hygiene compliance will become critical, but it is often difficult for healthcare environments to maintain.

One of the best ways to improve compliance rates is to make the procedures quick and easy to follow – without undermining their efficacy.

From the time it takes to perform an alcohol-based sanitiser event, to the size of hands involved in the procedure, there is no single answer for every individual looking to practise effective hand hygiene

And that is where the challenge lies. Even the latest research into the elements of hand hygiene compliance, including product volume and hand coverage, shows that providing effective procedures is not a one-size-fits-all exercise.

From the time it takes to perform an alcohol-based sanitiser event, to the size of hands involved in the procedure, there is no single answer for every individual looking to practise effective hand hygiene.

But that does not mean that organisations should not look for processes that make compliance as easy as possible for the greatest number of people.

A recent experimental study investigated the effect that different amounts of time spent rubbing alcohol-based sanitiser into the hands has on microbe reduction.

The researchers discovered that test subjects rubbing their hands for 30 seconds did not see much more of a reduction than those rubbing their hands for 10, 15 or 20 seconds. This suggests that individuals could look to cut down on the time they spend on each hand hygiene interaction – potentially making compliance easier to achieve, especially in hospitals, which have hundreds of these moments every day.

Another factor researchers have looked at is the amount of sanitiser used during each hand hygiene moment.

Within one study, researchers came to the conclusion that, to keep the hands moist for a 30-second rub, a higher volume of sanitiser would be needed – in the range of 2ml.

However, a higher volume of sanitiser could prove too much for a shorter hand rub of around 15 seconds – leaving the hands moist, and workers waiting for their hands to dry before they can carry on with patient care.

Healthcare establishments and individuals looking to improve hand hygiene in their workplaces could be forgiven for thinking that the ‘results’ from recent research into the topic of hand hygiene are inconclusive

This would then create inefficiencies that would add up to significant amounts of time over days, weeks and months. It would also likely have a severe negative effect on hand hygiene compliance.

In support of a lower volume of sanitiser, the research highlights that 95.7% of healthcare workers see 1.5 ml as sufficient for hand coverage. But, again, the researchers point to the fact that the simplicity and effectiveness of the hand hygiene technique can have a significant impact on the reduction of microbes, the perception of its use by workers and overall compliance.

Healthcare establishments and individuals looking to improve hand hygiene in their workplaces could be forgiven for thinking that the ‘results’ from recent research into the topic of hand hygiene are inconclusive.

As mentioned above, there is no one-size-fits-all solution to the issue. But one indisputable fact is that facilities with higher compliance rates will have a better chance of tackling AMR and preventing infection.

Ultimately, to improve compliance across their facilities, healthcare organisations need to make each hand hygiene moment as simple as possible. This means putting procedures in place that everyone can follow – with consistent techniques, timings and volumes used to ensure efficacy.

The majority of this process can be covered by training sessions and toolbox talks, but leaving workers to look after their own volumes of sanitiser each time they came to cleanse their hands would be a recipe for disaster.

For starters, how would people know they had the right amount? And how do you prevent them using too little or too much? Either way, the system would become so inefficient that it would not take long before compliance dropped significantly. Again, the answer is to make the whole exercise simple.

One indisputable fact is that facilities with higher compliance rates will have a better chance of tackling AMR and preventing infection

What healthcare organisations should look to use is an in integrated hand hygiene compliance and skincare programme that is customised to their specific environment.

Using such a system makes every hand hygiene moment so much simpler. To take advantage of a tailored programme and bring simplicity to their hand hygiene procedures, healthcare facilities are recommended to incorporate three key steps: providing the right products, monitoring compliance and promoting highest standards of staff behaviour through education.

Providing the right products involves a three-step hand hygiene protocol that should be followed by healthcare staff: cleanse, sanitise and care.

This revolves around staff members frequently using hand hygiene products at regular intervals recommended by the WHO ‘Five Moments’.

This field-tested, user-centred approach defines the key times when healthcare workers should perform hand hygiene – reducing the impact that AMR can have on a facility and its patients.

Alongside this, healthcare organisations are recommended to use a dispensing system they trust to provide a consistent amount of sanitiser each time a worker comes to use it. For example, with a set of dispensers that release 1.5ml of sanitiser with one push of a button, end users know that they do not have to use any more to ensure hand coverage. And administrators can rest assured that effective microbe reduction is taking place, without worrying about wastage.

To effectively gather data on hand hygiene practices healthcare facilities are encouraged to implement an electronic monitoring system that allows them to capture 100% of hand hygiene events, and accurately track compliance rates across their facilities. This step is important as it provides information on dispenser usage, giving administrators the insight they need to identify problem areas and the key issues to tackle.

From here healthcare facilities should implement a dedicated education and training platform that enables them to makes sure the highest standards of behaviour are in place at all times.

Healthcare facilities are recommended to incorporate three key steps: providing the right products, monitoring compliance and promoting highest standards of staff behaviour through education

The use of a training toolbox – designed to change behaviour by educating staff about best practice in how, why and when to engage in hand hygiene – enables administrators to act on the insight gained from their monitoring system. It also allows healthcare facilities to provide teams with feedback on their performance – impressing on them how little reason there is not to follow protocols when one push of a button is all it takes to make the most of every hand hygiene moment.

To tackle the rising threat of AMR and prevent infection, healthcare organisations have to drive compliance – and the best way to do that is to make hand hygiene simple. And what could be simpler than to hit a button once to get the same amount of sanitiser every time? It only takes a moment to get hand hygiene right.

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