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News|Articles|March 13, 2024

Hand Hygiene Practices in the Operating Room: A Collaborative Endeavor

As explained on a poster at AORN 2024, perioperative nurses and infection preventionists unite in a proactive campaign to elevate hand hygiene within the operating room, resulting in improved adherence, decreased infections, and fortified patient outcomes.

This issue is the topic of a poster presented at the Association of periOperative Registered Nurses’ (AORN’s) International Surgical Conference & Expo 2024, held from March 9 to 12, 2024, in Nashville, Tennessee. The poster titled “Hands-on Partnership to Improve Intraoperative Hand Hygiene” explained one study of hand hygiene practices by Kimberly Mitchell, MSN, APNP, ACNS-BS, CNS-CP, CNOR; Anastasia Meyers, ADN, RN, CNOR; Jacob Schermetzler, MLS (ASCP), CIC, all working at Aurora St. Luke’s Medical Center.

In the health care industry, strict hand hygiene practices are crucial. Health care workers' hands serve as both healing instruments and potential sources of infection, making hand hygiene adherence rates an ongoing challenge. Studies have shown that hand hygiene adherence rates remain between 60% and 70%, highlighting the need for continuous infection prevention efforts.

The Role of Perioperative Nurses: “Perioperative nurses play a key role in advocating for the patient in the operating room, including ensuring an appropriate environment which includes hand hygiene,” the authors wrote on the poster.

Purpose and Approach: Two operating room (OR) shared governance committees at a prominent Midwest tertiary care hospital took a significant step toward bolstering hand hygiene practices. This proactive stance led to forming a multidisciplinary intraoperative hand hygiene committee supported by surgical services and infection prevention leadership.

Key Initiatives: The committee's mission encompassed various crucial steps:

  • Rigorous Baseline Data Collection: Evaluating surgical hand scrub techniques, glove usage, and gel application.
  • Development of Specialized Audit Tools: Tailoring tools for monitoring hand hygiene practices within the OR.
  • Implementation of Strategic Measures: Initiatives to enhance priority hand hygiene metrics identified through comprehensive audits.
  • Transparent Reporting: Monthly dissemination of findings to governance committees and key stakeholders.
  • Dynamic Interventions: Recognizing the need for sustained engagement, the committee introduced a range of strategies:
  • Regularly Updated Postings: Timely rotation of educational materials and prompts.
  • Refinement of Audit Tools: Enhancements based on data analysis and committee meetings.
  • Staff Empowerment: Assigning audits to non-committee members for broader engagement.
  • Educational Initiatives: Continuous updates and rotations of materials to promote awareness.
  • Interactive Bulletin Boards: Introducing contests to foster hand hygiene awareness and participation.

Results and Implications: The committee's efforts yielded significant results:

Throughout 2022, 1275 observations were made, followed by 1662 more by October 31, 2023. These observations aimed to identify critical opportunities for improving hand hygiene.

The adoption of hand hygiene adherence as a standard quality metric in Surgical Services is directly linked to a decrease in surgical site infection rates. The journey towards improved hand hygiene practices is ongoing and requires continuous measurement and staff engagement. This is essential for achieving advancements in practice and better patient outcomes. It is important to recognize the critical role of hand hygiene, especially surgical hand scrubs, and to continuously measure and involve staff in enhancing these practices.

Partnerships with infection prevention can lead to mutual benefits such as improved interventions, enhanced process measurement, and better patient outcomes and staff safety.

The conference runs from Saturday, March 9, to Tuesday, March 12, 2024. For all ICT’s coverage, go here.

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