Visual Triggers Increase Hand Hygiene Compliance

Bacteria grown from a workstation on wheels. Courtesy of Henry Ford Hospital

Can you use the “ick factor” to get healthcare workers to clean their hands more often? Yes, according to a new study being presented on June 11 at the 43rd Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).

The infection control team at Henry Ford Health System in Detroit used images of bacterial growth to provoke feelings of disgust and motivate hospital staff to comply with hand hygiene guidelines. The team developed a book of images containing bacterial cultures of differing types and levels of contamination, as measured by Adenosine Triphosphate (ATP) meter readings. They tested the images on hospital units that had low hand hygiene compliance rates, and over a two-month period, they visited those units 10 times, sampled workers’ hands for bacteria, and then showed them pictures of cultures similar to the contamination on their hands. Compliance increased by between 11 and 46 percentage points in units where the study was conducted.

“Hospital staff wanted to wash their hands after looking at the book and picturing similar contamination on their own skin,” said Ashley Gregory, MSL (ASCP), an infection prevention specialist who co-led the project. “Using this example, other institutions may be able to change behavior and improve their hand hygiene compliance rates by influencing staff to connect the images of microbial contamination with non-adherence to hand hygiene guidelines.”

The program also motivated healthcare personnel (HCP) to take ownership of the environmental cleaning of their workspace. By comparing the ATP readings taken from phones, mobile work stations, and computer mouse devices to the photos in the book of germ images, HCP were able to visualize the contamination on the surfaces surrounding them.

“Hand hygiene is one of the most important ways to prevent the spread of infection, and yet it can be one of the most difficult benchmarks to improve,” said APIC 2016 president Susan Dolan, RN, MS, CIC, hospital epidemiologist, Children’s Hospital Colorado. “The visual nature of this approach proved successful for the team at Henry Ford Health System, and it may offer an effective strategy for other healthcare facilities that are looking for ways to change behavior and improve hand hygiene compliance.”

Henry Ford’s infection control team was inspired by new research from St. John’s Research Institute in the United Kingdom, which found that leveraging emotional motivators in Indian villages was more effective at promoting behavioral changes in hand hygiene than traditional messaging.

According to the Centers for Disease Control and Prevention, more than 700,000 healthcare-associated infections occur in U.S. acute care hospitals every year. It is well documented that effective hand hygiene helps reduce the spread of infections. Despite this evidence, HCP practice hand hygiene less than half of the times they should.

APIC 2016 Annual Conference, June 11-13 in Charlotte, N.C., is the most comprehensive infection prevention conference in the world, with more than 60 educational sessions and workshops led by experts from across the globe and attended by nearly 4,000 professionals. The conference aims to provide infection preventionists, physicians, researchers, epidemiologists, educators, administrators, and medical technologists with strategies that can be implemented immediately to improve prevention programs and make healthcare safer. Join the conversation on social media with the hashtag #APIC2016.

Source: APIC