According to the WHO, the best way, to improve patient safety and especially hand hygiene is to develop a multimodal strategy; applying several interventions in an integrated way [1]. A multimodal strategy needs to be tailored to the actual hospital, considering local structural and cultural aspects. As a good combination differs from hospitals to hospitals, most of the effective multimodal strategies have been built from the same cornerstones [2]. If you plan to develop your own hand hygiene improvement strategy, consider to
- Make hand hygiene product available everywhere, especially at the point of care. Use of personal handrub bottles can also be an option.
- Track usage of hand hygiene supplies (ABHR)
- Keep on eye on ward occupancy and workload
- Educate frontline healthcare workers (HCW)
- Organize training not only for HCW but also for managers
- Provide additional training materials
- Use guidelines in combination with education/training
- Monitor hand hygiene compliance and technique
- Set compliance goals and provide feedback
- Routinely screen for antimicrobial resistant organisms
- Run active HAI (healthcare-associated infections) surveillance
- Standardize audits and run it regularly
- Place reminders (e.g. posters)
- Find role models and involve them
- Engage all relevant stakeholders
- Involve patients, and their families, if applicable
- Apply positive reinforcement; e.g. financial incentives or other reward based on performance
- Promote safety culture
- Regularly publish and promote latest results of the program
A good combination of the above interventions can induce hand hygiene behavioural change. Keep in mind, that implementation of such a complex multimodal program requires at least 5 years of commitment [1].
