Project Description
HSR Case Study: National Australian Hand Hygiene Initiative
The Project
The National Australian Hand Hygiene Initiative (NHHI) introduced in 2009 promoted the WHO's “5 Moments for Hand Hygiene” resource, which highlights the key times when healthcare staff should clean their hands, such as before and after touching a patient or after being exposed to bodily fluids. The campaign included training healthcare workers with educational resources developed for specific groups including nurses, doctor and non-clinical staff. Compliance with the “5 moments” regime was regularly checked by trained “auditors” and results were publicly reported. The campaign also included a drive to raise awareness of hand hygiene among patients.
The Problem
Hospital-acquired infections are a major concern for hospitals around the world and Staphylococcus aureus bacteria (S. aureus) is among the most dangerous. The risks to patients and the associated hospital costs are enormous. Despite the evidence that good hand hygiene is important, getting people to stick to hand washing regimes is notoriously difficult and few national programmes have been sustained in the long-term.
The Impact
Research shows that since its implementation in 2009, the NHHI has seen significant and ongoing improvements in hand hygiene among healthcare workers, with compliance in hospitals nationally, rising from 64% of potential hand hygiene opportunities in 2009 to 84% in 2017.
The campaign has also been linked to a reduction in S. aureus bacteria, a leading cause of acute pneumonia and sepsis. For every 10% increase in hand hygiene compliance, researchers found an associated 15% drop in the incidence of S. aureus bloodstream infection in Australia’s 132 largest public hospitals. However, compliance levels varied between different types of staff with adherence to hand hygiene routines consistently 10-15% lower among doctors compared with nursing staff across the eight-year study.
The NHHI programme could be a blueprint for similar initiatives in other countries struggling to improve hand-washing practice and might be a template for other national culture-change initiatives in healthcare.
M Lindsay Grayson, Andrew J Stewardson, Philip L Russo, Kate E Ryan, Karen L Olsen, Sally M Havers, Susan Greig, Marilyn Cruickshank
Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study
The Lancet Infectious Diseases, Volume 18, Issue 11, November 2018, Pages 1269-1277
