title: Patient-centred hand hygiene information in orthopaedics units: an evidence-based implementation project.
abstract: OBJECTIVE
  This project aimed to improve patients' knowledge on the importance of hand hygiene. It involved providing patients with a patient and family education on the importance of hand hygiene using a patient information leaflet that introduces the rationale of hand hygiene, possible consequences of poor hand hygiene, and the seven steps of hand hygiene.
  
  
  METHODS
  This projected used a preimplementation and postimplementation audit strategy using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research Into Practice programs. The implementation occurred in three phases over a period of 6 months from January 2014 to June 2014. The audits took place in two orthopaedic wards in a large acute care setting tertiary hospital in Singapore and involved a sample size of 54 patients. It involved going through the medical records of the cases, assessment of patient knowledge based on the audit criteria, and checking if the patients received the patient information leaflet on hand hygiene.
  
  
  RESULTS
  The postimplementation audit found significant improvements in all three audit criteria. The percentage of patients who demonstrated knowledge in the importance of hand hygiene saw an improvement of 48.1%. There was an improvement of 44.5% in nurses' compliance to the documentation of patient education being carried out. The percentage of patients who received a patient information leaflet on hand hygiene saw an increase of 36.1%.
  
  
  CONCLUSIONS
  This project demonstrated that a preimplementation and postimplementation audit is a viable method to implement change and translate evidence into practice. Through this project, patients gained an understanding on the importance of hand hygiene and could take better ownership of their well being. This may potentially improve hospitalization experience and benefit health outcomes. The positive results of this project are contributed by the enthusiastic involvement of all the stakeholders, from patients and their caregivers to the bedside nurses and nursing leaders. The sustenance will be an ongoing challenge to the project.
authors.affiliation: 1Nursing Department 2Evidence Based Nursing Unit, National University Hospital, Singapore, Singapore.
authors.forename: Arielle Yi Jia
authors.initials: AY
authors.lastname: Ong
authors.forename: Joanne
authors.initials: J
authors.lastname: Tan
authors.forename: Hui Ling
authors.initials: HL
authors.lastname: Yeo
authors.forename: Mien Li
authors.initials: ML
authors.lastname: Goh
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D055317:Evidence-Based Practice; D063373:Hand Hygiene; D007722:Health Knowledge, Attitudes, Practice; D006748:Hospital Departments; D006801:Humans; D024802:Nurse's Role; D009985:Orthopedics; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D012846:Singapore; D062606:Tertiary Care Centers