uci school of nursing students find that patient hand hygeine is inconsistently emphasized female hands dispensing hand sanitizer

Five recent graduates of the UCI Sue & Bill Gross School of Nursing noticed an inconsistent emphasis on patient hand hygiene in the hospital, so they started a project to find a solution.

Their paper,Importance of Patient Hand Hygiene Education and Accessibility of Hand Sanitizers‘ was published in The Infection Prevention Strategy.

Accessibility and messaging

Access to soap, water and hand sanitizer can be inconsistent in the hospital setting.

Further, hand hygiene messaging usually focuses on healthcare staff.

The students found that this creates a domino effect in which the risk of infection rises throughout the hospital, leading to longer stays, which strains resources and increases costs. In worst cases, hospital-acquired infections (HAIs) lead to patient deaths.

HAIs contribute to 90,000 deaths each year, more than deaths from prostate and breast cancer combined.

Improving patient hand hygiene

The students set out to increase:

  • Accessibility of hand hygiene supplies
  • Patient hand hygiene knowledge
  • Hand hygiene compliance

Patients selected for the project were high fall risk or immobile, but alert.

To make hand sanitizer readily available, the students placed a bedside caddy called Fitsi near the patient. Patients were then easily able to dispense sanitizer without assistance.

Students gave the patients hand hygiene education and a quiz before giving them a Fitsi. The next day, each patient recieved another round of education and a quiz.

The information had a positive effect: Awareness that handwashing is the best way to prevent infection increased by 45%.

Once patients had hand sanitizer at their bedside, compliance improved by 15% and patients reported washing their hands four times a day or more.

A human-centered approach

The students conclude that improving patient hand hygiene requires a holistic, human-centered approach to drive behavior change.

The students on the project were Sarah Yoon, Emmanuel Raphael Santuray, Dion Bui, Tiffany Thanh Quach and Patricia Osuna, all members of the Class of 2020.

Their project is part of the undergraduate program’s required course in leadership and management (NS160) and the Master’s Entry Program in Nursing (MEPN) (NS276). Their clinical immersion consists of being paired with UCI Health leaders and managers to work on quality improvement projects.