Compliance to hand hygiene practice among nurses in Jimma University Specialized Hospital in Ethiopia: a best practice implementation project

Abstract

Background: Hand hygiene practice reduces cross-contamination and infection, and it makes sense from a resource saving perspective. The hospital costs associated with a reduction of four or five Health Care Associated Infections may equal the entire annual budget for hand hygiene products. Objective: The objective of this best practice implementation project was to promote evidence informed best practice of hand hygiene among nurses in Jimma University Specialized Hospital Out Patient Department. Methods: An inter-professional project team conducted baseline and post implementation audits using Joanna Briggs Institute Practical Application of Evidences System (JBI PACES). Using six audit criteria, 163 hand hygiene opportunities were observed for both a baseline and follow-up audit. Seven nurses were interviewed for the seventh criteria. Results: The baseline audit revealed a compliance of 2% for using an effective hand washing technique involving three stages, and 4% for washing hands that are visibly soiled with liquid soap and water. Post implementation audit showed an average of 80% improvement in compliance to the evidence based audit criteria for effective hand hygiene. Conclusions: This project showed that role modeling, posting reminders about hand hygiene procedures and presenting evidence summaries to the clinical teams are strategies that result in improved adherence to best available evidence for hand hygiene. Involving key stakeholders in identifying the strategies to change practice is essential for the realization of the implementation of effective hand hygiene. A regular program of random audits conducted by an inter-professional team can help to achieve sustainable compliance to effective hand hygiene.