1. Hand Hygiene
a. The current issue on my unit, and an issue that has been present since last year,
is the lack of hand hygiene. This is extremely
... [Show More] pertinent as hand hygiene is essential to providing
adequate patient care. According to the CDC, about 1 in 25 patients acquires a health careassociated infection (HAI) due to poor hand hygiene during their hospital care, resulting in up to
722,000 infections a year. Of these, 75,000 patients die of their infections (Hand Hygiene in
Healthcare Settings, 2018). Performing hand hygiene is considered to be the most important
infection prevention measure; thus, to prevent contamination, good hand washing must be
practiced. This is particularly important on my unit as I work on an Orthopedics floor with
medical overflow. Because of the medical overflow, there is a higher chance of spreading an
infection, especially to the orthopedic patient. On a typical day I have 5-6 patients and will
constantly be in and out of each room touching the patient and various equipment. Without
performing proper hand hygiene, my patients are exposed to many surrounding infections.
2.
a. Currently, the hand hygiene compliance results on my unit from December
2017 to May 2018 are as follows:
December: 58.5%
January: 81.1%
February: 100%
March: 72.1%
April: 71.7%
May: 66%
The 6th month rolling total is 70.4%, putting my unit as the worst floor for hand hygiene
compliance out of 27 units. In addition to this, an audit that was randomly taken during a day
shift for the month of May, showed 30% hand hygiene compliance. Clearly, there is poor
compliance in regards to hand hygiene on my unit.
3.
a. There are several issues that may be contributing to this problem. First, lack of
education. There are no educational boards or signs in the unit regarding the importance of hand
hygiene and the risks that come with poor compliance. Second, the stress of having 5-6 patients
and at times total patient care patients, which means there is no CNA for that particular patient,
and the RN is responsible for total care. This results in the RN feeling overwhelmed and
overlooking hand hygiene dispensers. Third, carrying too many supplies and thus failing to
perform hand hygiene. Lastly, there are no rewards for good hand hygiene compliance.
4.
a. There are numerous ways to help improve hand hygiene compliance. First and
for most, I would create educational projects. I would post educational posters in the break room,
conference room, bathrooms, and one at either nurses’ station. Along with this, I would present
statistical information regarding the risks of failing to perform hand hygiene at several meetings.
I would also educate the patient that it is okay for them to ask if their health care team has done
hand hygiene, this will keep the health care team accountable. In addition, I would place large [Show Less]