Patient hand hygiene in a residential aged care facility: a best practice implementation project

ABSTRACT Introduction: Hand hygiene for both health care workers and patients is an important measure to prevent health care-associated infections in residential aged care facilities. Studies on health care workers’ and patients’ perceptions and behaviors have indicated that despite understanding its importance, patient hand hygiene is not a deliberate practice. Objective: This project aimed to promote evidence-based practices regarding patient hand hygiene in a residential aged care facility. Methods: Guided by the JBI Evidence Implementation Framework, six best practices were used as audit criteria. Baseline audits were conducted through observations, staff surveys, and electronic health record reviews. Barriers to best practices were identified and strategies were implemented to address those barriers. Follow-up audits were conducted and compared to baseline results. Results: The baseline results showed 64% compliance with the six best practice recommendations. Barriers included health care workers’ lack of knowledge of the multimodal approach to patient hand hygiene, limited hand hygiene products, patients’ inability to use products independently, and missing or inaccurate education documentation in the health record. Strategies to improve compliance included education for health care workers, increasing the availability and usability of hygiene products, and standardizing patient hand hygiene documentation in the electronic health record. Post-implementation audits showed a 12% increase in compliance, which rose to 76%. Conclusions: Through education initiatives, increased product accessibility, and standardized documentation, this evidence implementation project successfully improved adherence to best practices for patient hand hygiene in a residential aged care facility. Sustained efforts, including integration into staff orientation and competency programs, will be critical to maintaining these gains. Spanish abstract: http://links.lww.com/IJEBH/A567