Introduction
Hand hygiene is highly regarded as one of the most substantial intervening dimensions for infection control. With the spontaneous increase in healthcare attributed infections problems, healthcare providers are referring back to take careful consideration into simple basic essentials to prevent infections such as ensuring proper hand hygiene (Knighton et al., 2017). Apparently, hand hygiene is the most simple and efficient intervention measure appropriate for the prevention of nosocomial infections. Adequate scientific evidence endorses the application of hand hygiene since it can significantly reduce the transmission of infections in ambulatory surgery centers (Assessing hand hygiene compliance among healthcare workers in six Intensive Care Units, 2017). Nevertheless, an integrated plan is required to be developed so as to make sure that all OR personnel in ambulatory surgery centres observe the guidelines provided. So, this paper proposes a comprehensive plant that will improve compliance to hand hygiene guidelines by all OR personnel in ambulatory surgery centres.
Problem
Typically, the efforts to promote hand hygiene have been a bigger challenge for the infection control professional. Various intervention strategies such as workshops and seminars, in-service training, circulation of informative leaflets, and the level of compliance have been attributed to ephemeral improvement (Pronovost, 2015). There has not been any intervention that has constantly enhanced compliance to hand hygiene practices. The prevalence rate of infections related to hand hygiene has been growing despite the hand hygiene guidelines in place. Health practitioners especially OR personnel have been a major cause of these nosocomial infections due to their negligence and failure to comply with the hand hygiene guidelines provided.
Research evidence
Research was carried out on 8 hospitals using multifaceted approaches which include: Six Sigma, Lean and change management in order to facilitate the improvement of their OR personnel compliance (Santosaningsih et al., 2017). These approaches were used to thoroughly conduct an assessment to determine what causes hand hygiene non-compliance and as a result foster improvement in compliance in the 8 hospitals in the United States. Collectively, the hospitals’ hand hygiene level of compliance significantly improved in the picked in-patient units by 71.6% while further sustaining the improvement for the next eleven months (Santosaningsih et al., 2017). Findings indicate that numerous aspects were attributed to this achievement and most probably also the substantial deliberations within programs’ the design and their implementing strategies. Initially, twenty-four were identified to be the causing hand hygiene catastrophes in the inpatient units in all the 8 hospitals that were participating in this research.
Secondly, the most vital finding was that the twenty-four causing factors were unevenly dispersed among all the 8 hospitals. Definitely, the most effective finding was that those main causes varied among the hospitals. Every hospital established and implemented different intervening strategies, each strategy aimed at one of the ideal resultants of hand hygiene catastrophes (Santosaningsih et al., 2017). Suppose one fails to determine the exact reason causing hand hygiene failure and the precise causes are more dominant in a certain hospital, it will, therefore, be impossible to design effective interventions.
This study was successful, managing to improve the hand hygiene compliance in the eight hospitals by 34.4 % from 47.1% to 81.5%while maintaining the high improvement level for the next eleven months (Santosaningsih et al., 2017). Every hospital had a unique main hand hygiene catastrophe causing factors while implementing appropriate interventions designed to aim at its vital main causes. Therefore such it is vivid that a targeted approach like this might be more effective and practical as compared to a single approach improvement strategy.
Hand Hygiene Compliance Intervention Plan
First, a multifaceted approach has to be adopted since it proves to be more effective than a single intervention approach. Most preferably, Six Sigma, Lean and change management approaches should be used. Second, direct observation accompanied by frequent reminders and constant feedback needs to be exploited in order to improve hand hygiene compliance. Process indicators are vital for in determining reasons why some interventions are successful while others fail (Improving hand hygiene compliance for the reduction of nosocomial infections). In observation, copying strategies have to be specified. Third, documentation of the observation made on how the OR personnel comply with hand hygiene guidelines. These data are then assessed to determine the level of compliance (Evaluating brief motivational and self-regulatory hand hygiene interventions, 2015). Forth, training, education, and provision of written information providing guidance on how to ensure OR personnel have the knowledge of how to observe hand hygiene standards effectively and the importance of complying with it. Fifth, conduct regular surveys on OR personnel to determine their level of knowledge and attitude towards their personal hand hygiene practices. Sixth, set up a multidisciplinary team to be in charge of punishing those that fail to comply with hand hygiene standards.
Implementation of the Plan
This intervention plan can be effectively implemented by first setting up a task panel in the hospital to spearhead the implementation process and as well come up with terms and conditions for the plan that will be complied with. The task panel members have to be assigned various units to conduct observations relating to the OR personnel hand hygiene practices then compile document all the finding noted. Moreover, regular training and education on good hand hygiene practices and the significance of complying with hand hygiene standards have to be by either the leaders or an external professional contracted. The task panel has to regularly conduct surveys to determine their level of knowledge and attitude towards their personal hand hygiene practices. An independent disciplinary committee has to be formed to exercise disciplinary action on OR personnel who fail to comply with hand hygiene guidelines.
Limitations of the plan
This intervention plan does not enforce 100% compliance of the OR personnel with hand hygiene standard but rather improve the level of compliance. The OR personnel may pretend to comply with hand hygiene standards when being only when being observed and quit complying when not being observed. Documented information may be incorrect thus might affect the type of measures to be used to exploit.
Purpose of the plan
This intervention plan intends to address the issue of increased non-compliance with hand hygiene standards. It proposes a strategic intervening approach that is significant in improving hand hygiene standards compliance.
Timeline
The implementation process of this intervention plan should take 6 months so as to attain significant changes. Observations have to be conducted weekly and documented every month. Surveys of OR personnel knowledge on hand hygiene standards need to be conducted after every two months.
Evaluation
Evaluation of the effectiveness of the intervention plan needs to be carried out every three months. Consistent monitoring of the level of improvement in hand hygiene guidelines compliance has to be done.
Conclusion
In essence, having a strategic and appropriate hand hygiene intervention plan is important in improving OR personnel compliance with the hand hygiene standards. Moreover, it is clear that a multifaceted approach proves to be more effective than a single intervention approach in improving OR personnel compliance. It is vivid that having a proper plan facilitates identification of main causes of infections attributed to hand hygiene, OR employees compliance weakness while providing intervening proper strategies that will improve hand hygiene standards compliance. Therefore, this hand hygiene intervention plan is significant in playing a role to minimize the burden of nosocomial infections