Hand Hygiene Reports, Hand Hygiene Education, Hand Hygiene Compliance, Hand Hygiene Measurement

Rumbana, R. et al. A Point in time observational study of handwashing practices of HCWs in ICU of St. Like’s Medcial Center. Phil J Microbiol Infectious disease 2001;30 10: 3-7.

Results: 218 opportunities in 24 hours. 9 HH per hour. This was a 12 bed ICU

Rupp M, et. al. Prospective, controlled, cross-over trial of alcohol-based hand gel in critical care. Infection Control and Hospital Epidemiology 2008;291:8-15.

Results: 12.3 HH/hr. Performed 17,994 min (299 hrs) observation on 2 med-surgical ICU's for 60 days by 10 trained observers (6 ICPS, 4 assts) in 20 min increments over 2 weeks.)

Although this is higher than 6 HH/hr we use, our measurement is based on 24/7 cycle.

Swaboda,S et al. Electronic monitoring and voice prompts improve HH and decrease nosocomial infections in an intermediate are unit. Critical Care Med. 2004;32 2.

Results: Observations on exit from room, mean 4 per hour, This was an intermediate step down unit.

McArdle, F. How much time Is needed for HH in ICU….Journal of Hospital Infection Control 2006;62:304-310.

Results; Direct contact 158 per day

Non_ICU –MMI - goals: 72HH per day – 3 per hour

Raboud, J et al. Patterns of handwashing Behavior and Visit to Patients in a General Medical Ward: Infection control Hospital Edpid. 2004;25 3.

Results: HCW visit to patient room 1 every 25 minutes approx 3 hour

Walanakunakorn, C. An observational study of hand washing and infection control practices by HCWs. Infection Control and Hosp Epidem. 1998: 858-60.

Results: Compared by observation the difference in compliance for ICU versus general units. They reported that Non ICU compliance was consistently less than half of ICU. We believe this indirectly supported our number for non ICU.

LTC/Rehab: MMI goal 20HH/patient day

Unpublished research conducted by one of our sites involving the 3-month study of 476 LTC/Rehab sites (observational data): we determined the mean compliance was 20HH/per resident-day.

Pediatrics; MMI goals 72HH per paitent bed day = 3 per hour.

Unpublished data obtained via observation and survey of our sites.

For the above four categories (ICU, Non-ICU, LTC/Rehab, and Pediatrics) we do benchmarking. For our out patient sites, we will not benchmark until the database increases and we have determined better compliance goal. At the present time, after surveying our sites, we have decided to use the following hh rates for the remaining two categories (Clinic and ER/OP):

Clinic; 3HH per visit

ER/OP: 6HH per visit

We define OP to be areas such as vascular lab, pre op holding, catherization. When sites send OP data, we request that they define their opoluaiton and clinical tasks to determine the best fit.

Research Used for This Website:

Kaplan L.M. and McGuckin, M.B. Increasing Handwashing Compliance with More Accessible Sinks. Am J Infect Control, 14:408-410, 1986.

McGuckin M, Waterman R, Porten L, Bello S, Caruso M, Juzaitis B, Krug E, Mazer S, Ostrawski S. Patient Education Model for Increasing Handwashing Compliance. Am J Infect Control, Vol 27 (4);309-314, 1999.

McGuckin M, and Porten, L. Handwashing Education Practices: A Descriptive Survey. Clinical Performance and Quality Health Care, Vol 7,No. 2, 94-96, 1999.

McGuckin M, Waterman R, Storr J, Bowler CJW, Ashby M, Topley K, Porten L. Evaluation of Patient Empowering Hand Hygiene Programme in UK. The Journal of Hospital Infection, 48:222-227 2001.

McGuckin M, Taylor A, Martin V, Porten L, Salcido R. Evaluation of a Patient Education Model for Increasing Hand Hygiene Compliance in an In-Patient Rehabilitation Unit. American Journal Infection Control ,32:235-8, 2004

McGuckin M, Porten L, Schmidt R, Streed S, Validation of a Comprehensive Infection Control Program in LTC. Director, Vol 12;1:14-17, 2004

McGuckin M, Waterman R, Shubin A. Consumer Attitudes About Healthcare-Acquired Infections and Hand Hygiene. Amer Journal of Medical Quality. 21:1-5, 2006

McGuckin M, Shubin A, McBride P, et al. The Effect of Random Voice Hand Hygiene Messages Delivered By Medical, Nursing and Infection Control Staff On Hand Hygiene Compliance In Intensive Care. Amer Journal of Infection Control. Dec 2006.

Quaraishi, Z. and McGuckin, M.B. Duration of Hand-Washing Frequency in Two Intensive Care Units. Am J Infect Control, 12:83-87, 1984.

Website CDC Guidelines - http://www.cdc.gov/handhygiene

Website National Patient Safety Foundation - http://www.npsf.org/

Website World Health Organization - http://www.who.int/gpsc/resources/newsalert/may2006/en/

Research for Buddies Handhygiene Program:

Butz AM, Larson EL, Fosarelli P, et al. Am J Infect Control, 1990:18;347-53.

Early E, Battle K, Cantwell E. English J. et al. Effect of several interventions on the frequency of handhygiene among elementary publich school children. Am J infect Control. 1998:26;263-69.

Guinan M, McGuckin M, Savareid A. Who washes hands after using the bathroom? Am J Infect Control. 1997:25;424-5.

Guinan, M , McGuckin, M, and Ali, Y. .The Effect of a Comprehensive Handwashing Program on Absenteeism in Elementary Schools. Am J Infect.Control: 2002;50:217220.

Guinan M. Hand hygiene practices in a school setting in UK (personal communication), 1999.

Master D, Longe SH, Dickson H. Scheduled hand washing in an elementary school population. Fam Med. 1997:29:336-9.

McGuckin Methods International, P. O. Box 425, Ardmore, PA 19003

E-mail: mcguckin@hhreports.com