title: Outcomes of an infection prevention project focusing on hand hygiene and isolation practices.
abstract: Nosocomial infections are a major health problem for hospitalized patients and their families. Since the 1800s, hand hygiene has been recognized as the single best method to prevent the spread of pathogens and nosocomial infections. Despite this fact, many healthcare workers do not adhere to hand hygiene policies. The Centers for Disease Control and Prevention issued a guideline for hand hygiene practices in 2002. Multifaceted approaches to improve hand hygiene have been shown to increase compliance among healthcare workers and subsequently reduce infections. A performance improvement project was initiated to implement this guideline and other strategies to prevent nosocomial infection. This article summarizes the performance improvement processes and the preliminary outcomes on adherence to infection prevention policies related to hand hygiene and isolation practices. Clinically and statistically significant increases were noted for hand hygiene prior to patient care and in wearing masks when indicated. Nurses and patient care technicians had the greatest increases in compliance. Increases in hand hygiene after patient contact and wearing of gown and gloves were also noted, but results were not statistically significant. Nosocomial infection rates from antibiotic-resistant organisms decreased in the first surveillance, but rates increased during the 1-year surveillance. Consumption of alcohol-based foam disinfectant doubled from baseline. Findings are consistent with other published studies. The project will continue with further reinforcement and education over the second year.
authors.affiliation: Vascular and Thoracic Surgery Unit, Orlando Regional Healthcare System, Florida, USA. daleena@orhs.org
authors.forename: Daleen
authors.initials: D
authors.lastname: Aragon
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Sole
authors.forename: Scott
authors.initials: S
authors.lastname: Brown
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S.; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004352:Drug Resistance, Microbial; D016983:Enterococcus; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control; D019983:Guideline Adherence; D006235:Hand Disinfection / Q000379:methods / Q000592:standards*; D006801:Humans; D017053:Infection Control; D007318:Inservice Training / Q000458:organization & administration; D016106:Methicillin Resistance; D017063:Outcome Assessment, Health Care; D010356:Patient Isolation / Q000379:methods / Q000592:standards*; D010564:Personnel, Hospital / Q000193:education; D011159:Population Surveillance; D017410:Practice Guidelines as Topic; D011367:Professional Staff Committees / Q000458:organization & administration; D016730:Program Development; D015397:Program Evaluation; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control; D013211:Staphylococcus aureus; D017749:Total Quality Management / Q000458:organization & administration*; D014481:United States / Q000453:epidemiology; D020713:Vancomycin Resistance