title: The impact of the Hand Hygiene New Zealand programme on hand hygiene practices in New Zealand's public hospitals.
abstract: OBJECTIVE
  To detail the progress made by Hand Hygiene New Zealand (HHNZ) since 2011 and also describe the challenges experienced along the way and the factors required for delivery of a successful hand hygiene programme at a national level.
  
  
  METHODS
  HHNZ is a multimodal culture-change programme based on the WHO '5 moments for hand hygiene' approach. The key components of the programme include clinical leadership, auditing of hand hygiene compliance with thrice yearly reporting of improvement in hand hygiene practice, biannual reporting of the outcome marker, healthcare-associated Staphylococcus aureus bacteraemia (HA-SAB), effective communication with key stakeholders and the use of the front-line ownership (FLO) principles for quality improvement.
  
  
  RESULTS
  The nationally aggregated hand hygiene compliance has increased from 62% in June 2012 to 81% in March 2016. There has been improvement across all 'moments', all healthcare worker groups and a range of different clinical specialties. The rate of HA-SAB has remained stable.
  
  
  CONCLUSIONS
  The HHNZ programme has led to significant improvements in hand hygiene practice in DHBs throughout New Zealand. The principles of FLO are now widely used to drive hand hygiene improvement in New Zealand DHBs.
authors.affiliation: Clinical Lead for HHNZ, Clinical Microbiologist, Auckland District Health Board.
authors.forename: Joshua
authors.initials: J
authors.lastname: Freeman
authors.affiliation: National Coordinator, HHNZ and Hand Hygiene coordinator, Auckland District Health Board.
authors.forename: Louise
authors.initials: L
authors.lastname: Dawson
authors.affiliation: Senior Advisor for the Health Quality and Safety Commission.
authors.forename: Deborah
authors.initials: D
authors.lastname: Jowitt
authors.affiliation: Communications Advisor, HHNZ, Auckland District Health Board.
authors.forename: Margo
authors.initials: M
authors.lastname: White
authors.affiliation: Communications Advisor, HHNZ, Gravity Communications.
authors.forename: Hayley
authors.initials: H
authors.lastname: Callard
authors.affiliation: Nurse Manager, Infection Prevention and Control Service, Auckland District Health Board.
authors.forename: Christine
authors.initials: C
authors.lastname: Sieczkowski
authors.affiliation: Project Coordinator, HHNZ, Auckland District Health Board.
authors.forename: Ron
authors.initials: R
authors.lastname: Kuriyan
authors.affiliation: National Clinical Lead for Health Quality and Safety Infection Prevention and Control Programmes and Clinical Head of Microbiology, Auckland District Health Board.
authors.forename: Sally
authors.initials: S
authors.lastname: Roberts
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D063373:Hand Hygiene / Q000592:standards*; D006282:Health Personnel / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000458:organization & administration; D006801:Humans; D017053:Infection Control / Q000379:methods*; D009520:New Zealand; D058996:Quality Improvement / Q000592:standards*; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000517:prevention & control; D014944:World Health Organization / Q000458:organization & administration