The message that hand hygiene can prevent healthcare-acquired infections (HAIs) is clear, yet compliance remains an infection preventionist (IP)’s significant challenge. McGuckin, et al. (2009), in their 12-month multi-center collaboration assessing hand hygiene compliance rates at U.S. healthcare facilities, demonstrate that compliance can increase when monitoring of product usage is combined with feedback. McGuckin, et al. (2009) state, “Product usage is a cost-effective, less time-consuming method that provides the ICP with an overall compliance rate for each unit, representative of all shifts, and avoids the biases of selection and self-reporting.”
The researchers explain that although a number of federal agencies and other organizations (such as the Centers for Disease Control and Prevention, Joint Commission, and Institute of Healthcare Improvement) emphasize the importance of monitoring hand hygiene compliance, there is no standard for measuring it. McGuckin, et al. (2009) state, “Standardization of hand hygiene measurement should be the foundation of a compliance program and the process of applying a standard methodology will increase the probability of improving hand hygiene compliance.” They further point to a literature review by Haas, et al. (2007) that identified the three most frequently reported methods of measuring compliance: direct observation, self-reporting by healthcare workers and indirect calculation based on hand hygiene product usage.
McGuckin and colleagues monitored healthcare workers’ use of soap and sanitizer by collecting and counting empty product containers and separating the soap containers from the sanitizer containers. The total number of empty containers was provided by either the facility’s environmental services staff or by other staff members; this number was recorded either separately by each unit, or tallies for all units were combined and reported as a single facility-wide effort. Each facility’s IP was asked to record and submit patient bed-day data for each unit monitored for the study.
