Give Patients a Hand – a Clean Hand

An infection control program at Austin Health in Melbourne to improve hand hygiene practices among health care workers has achieved sustained improvement in hand hygiene, coinciding with a reduction of nosocomial (hospital-acquired infections) and transmission of MRSA in health care settings, according to an infection control nurse.

The DeBug Infection Prevention Program (DIPP) promoted an alcohol- chlorhexidine hand rub first pioneered by Professor Didier Pittet from the University of Geneva Hospital, Switzerland.

His studies demonstrated hand hygiene compliance was associated with a significant reduction in nosocomial infections.

Following the success of the project in using an alcohol- chlorhexidine hand rub in place of traditional hand washing practices at Austin Health, it has now been adopted as a pilot project by the Victorian Quality Council (VQC).

Clinical Research Coordinator RN Timothy Brown said the project focused on using alcohol-chlorhexidine based hand disinfection at the bedside, while providing education to health care workers to facilitate change management in hand hygiene practices.

‘Hand hygiene is the single most important measure to prevent cross-transmission of microorganisms from one patient to another,’ Mr Brown said.

‘Several studies have demonstrated reductions in nosocomial infection rates after hand hygiene practice improvement.

‘But efforts to improve rates of hand hygiene compliance by health care workers have generally been ineffective or poorly sustained. There is a range of reasons for this: it may be related to understaffing and high patient acuity allowing insufficient time for staff to wash their hands.

‘It could be avoidance if people have previously experienced skin irritations and dryness from other hand-hygiene solutions, or related to infrastructure, if sinks are inconveniently located.’

Other factors affecting compliance could be inadequate knowledge of guidelines or protocols for hand hygiene; lack of positive role models; and a perception that glove use negates the need for hand hygiene, Mr Brown said.

Alcohol-chlorhexidine hand rubs are considered to be superior to soap and water because they require less time to use; they are more effective in reducing micro-organisms; are less irritating to the skin; and can be made readily accessible to health care workers.

The health services and clinical research nurses participating in the pilot project are: Western Health (Jeffrey Brooks), Peninsula Health (Kaye Bellis), Melbourne Health (Celene McMullan), St Vincent’s Health (Katie Taylor), North-East Health Wangaratta (Roger Gregory), and Bendigo Health Care Group (Meryanda Jodoin). Each of the health services will pilot the rub, then introduce the practice from May 2005.

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Copyright Australian Nursing Federation Nov 2004

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