Hand Hygiene Practices as a Quality Indicator in Healthcare

Running head: NURSING ASSIGNMENT
Nursing assignment
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Introduction:
Hospital acquired infection is regarded as the leading cause of mortality, hospital stay and
health care cost. Hand hygiene practices is one quality indicator that predicts the quality and
safety in health care service. Compliance to hand hygiene practices is crucial to the prevention of
hospital acquired infection as this practice breaks the chain of infection that is transmitted from
staff to patient by direct contact. It is regarded as one major indicator of healthcare quality and
patient safety as it is an integral component of infection control standard (Mumford et al. 2014).
However, interventions implemented to improve hand hygiene and prevent infection differ based
on contextual setting and different cause of non-compliance. This report aims to discuss about
the quality indicator of hand hygiene and methods used for measurement of the indicator in a
specific clinical setting. Literature review on chosen indicator and quality improvement plan
related to the chosen indicator is also provided to improve quality and safety of care.
Discussion on indicator of quality and safety:
Hand hygiene practices relates to the use of soap and water, hand sanitizers or
disinfectants to prevent transmission of infection in clinical setting. Compliance with Hand
hygiene is regarded as one of the pillar of infection control and adequate hand hygiene practice is
crucial to reduce risk of infection, mortality, morbidity and health care cost. Health care
practitioners are looking back to the basics of hand hygiene to reduce transmission of infection in
hospitals (Mathur 2011). Compliance to hand hygiene can be regarded as an appropriate
indicator of quality and safety in a hospital’s quality improvement programme as improving
hand hygiene compliance rate has been found to decrease the rate of health care associated
infection (Sickbert-Bennett et al. 2016) According to World Health Organization (2017), empty

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alcohol dispense, failure to educate staffs regarding hand hygiene technique and failure to
practice hand hygiene after glove removes results in serious failure at important phases in the
patient care system. Failure to comply with hand hygiene practices at critical point results in
patient safety issues and poor clinical performance. Apart from patient and staff, the environment
of hospitals also plays a role in compliance to hand hygiene practice (Mathur 2011). Hence,
assessment of links between hand hygiene and compliance rate is crucial to identify the factors
affecting quality and patient safety and develop appropriate intervention to address individual,
organization and environment level barrier to hand hygiene practice.
There are different methods to assess compliance with hand hygiene practices among
health care staffs at St Vincent’s Private Hospital Melbourne. Monitoring and improving each
hand hygiene action can prevent sepsis in health care stetting and lead to optimal patient
outcome. This section provides an overview about methods used to measure the quality indicator
within St Vincent’s Private Hospital Sydney. The hospital is renowned for delivery of quality
patient care since the past 100 years. It has achieved optimal performance through the
commitment of experience team of health care professionals consisting of clinicians, support
staff and nurses. The hospital has an Infection Prevention and Control (IPC) team that works
with different staffs within the hospital to promote health and safety of patient, staffs and
visitors. The main aim of this collaboration is to eliminate risk of transmission of infection. The
environmental context that has helped the hospital to sustain hand hygiene practices includes
presence of appropriate hand hygiene culture and accessibility of hand foam dispensers at the
clinical setting. All nurse and staffs are training in correct hand hygiene procedure and hand
foam dispensers are available to each ward thus eliminating common barrier to hand hygiene
compliance (St. Vincent’s Private Hospital 2018). Hence, it can be said that that the hospital has

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a multi-disciplinary approach to improve hand hygiene practices and promote quality and safety
in care. Monsalve et al. (2014) states that individual and institutional factors are interdependent
in terms of behavioral change and improve hand hygiene practices in clinical setting.
The procedure that the IPC team has implemented to prevent infection includes education
of staff, infection prevention advice, audits, surveillance and development of IPC policies and
guidelines. The advantage of these activities for infection prevention is that it has the potential to
address individual as well as organizational barrier to infection control. Performance of staffs in
hand hygiene practices is measured by recruitment of trained observers and their role in looking
for moment or opportunities at which hand hygiene should occur. The number of audited
moments at the hospital was taken as a method to estimate compliance rate (myhospitals.gov.au
2017). The hand hygiene and infection prevention program indicates use of soap to keep hands
clean. The hospital also provides directive to patients to prevent infection. They encourage
visitors to clean hands before visiting hospital to prevent transmission of infection from outside
source. The screening program for carriage of MRSA has been the most beneficial initiative at
the hospital that has increased identification of infection risk and early treatment for patient (St.
Vincent’s Private Hospital 2018). The most effective measurement method at the hospital is use
of direct observation to measure quality indicator of hand hygiene. However, as the process is
time consuming, improvement in direct observation method is needed to gain accurate results.
Summary of literature on chosen indicator:
There are much research evidence that has used different hand hygiene protocol to
improve quality of care and reduce hospital-acquired infection. Chassin, Mayer and Nether,
(2015) used hand hygiene as an indicator to prevent infection and identify causes of non-