Hand Hygiene Audit

Combat hand hygiene audit fatigue by going digital

Hand hygiene audits ensure healthcare practitioners follow best practices for preventing the spread of infection. Practicing hand hygiene is a simple and effective way to prevent the spread of illness, especially in hospitals. The U.S. Centers for Disease Control and Prevention (CDC) stresses the importance of practicing good hand hygiene to combat the spread of pathogens, including the Covid-19 virus and antibiotic-resistant microbes.  

Heading into the third year of the COVID-19 pandemic makes hand hygiene more relevant than ever. The CDC emphasizes the importance of hand hygiene for both the public and healthcare professionals as part of an effective mitigation strategy. A recent article in the Journal of Clinical Nursing about the value of proper hand hygiene reminds us that our hands are “a critical vector for transmitting microorganisms”. “When nurses and other healthcare practitioners fail to clean their hands efficiently, they increase the cross-transmission of these organisms to their patients.”

Nurses and other healthcare professionals know the importance of good hand hygiene. Yet, the CDC estimates that healthcare providers clean their hands less than half the recommended times needed to prevent disease transmission. Using a hand hygiene audit plan that includes an audit tool from Xapimed is one way hospitals are improving their hand hygiene performance.   

How often should hand hygiene audits be performed?

More than half of all patient contacts are made by nursing professionals in hospitals and other healthcare settings. The findings are hardly surprising considering that nurses provide bedside care to patients that can include medication administration and personal hygiene. Frequent contact of this nature increases the likelihood of transmitting microorganisms that can cause illness. Nurses must therefore be priorities when collecting data about hand hygiene practices and included as part of the audit team. 

How often should hand hygiene audits be performed? At least once annually is the recommendation of the CDC and other disease prevention experts. Annual audits must include all staff, with a particular focus on nurses. 

Hand hygiene audit tools for compliance monitoring

Hand hygiene audits are not a novel concept. Hospitals and other healthcare facilities have conducted them for many years. Now, however, they have the benefit of tracking it more efficiently by combining age-old practices with technology designed to collect and analyze the data. A hand hygiene audit tool from Xapimed provides valuable insights to nurses , nurse leaders, and nurse educators about hand hygiene practices so they can make recommendations for changes that improve nursing practice and patient outcomes. Here’s how it works:

Auditors can use the Xapimed software tool on any device – mobile phone, tablet, computer, or workstations on wheels – to capture audit results about the person they are monitoring in real-time. The hand hygiene audit tool eliminates the need for manual entry of the data onto paper for transference into a computer file later. By eliminating the paper trail, auditors can improve data accuracy while increasing their productivity. They effectively remove a step in how the process previously was performed, which means they can produce results more quickly. 

The same auditing software tool provides the ability to assign remediation to nurses and other medical staff. The Xapimed program triggers follow-up audits for any staff member who may need to show post-remediation competency. Both the auditor and the person being audited receive the automated notice. 

Calculating hand hygiene compliance rate

Before a proper hand hygiene audit can be performed, hospitals and other healthcare facilities must determine a benchmark for hygiene compliance. According to the National Institutes of Health (NIH), an acceptable benchmark is 90 percent. Yet, a recent study during the height of the pandemic suggests compliance remains low, averaging 50 percent across all healthcare facilities in the U.S. 

To determine the facility compliance rate, healthcare staff make note of the number of times they perform hand hygiene for each of the indicators in the hand hygiene plan (XP). That number is divided by the number of times hand hygiene is observed by the auditor for the specific indication (XO). The result is multiplied by 100 to reveal the compliance rate percentage for hand hygiene in the entire facility:  XP ÷ XO × 100 = %C.

How to conduct a hand hygiene audit

The World Health Care Organization (WHO) published hand hygiene guidelines that outline best practices for washing and sanitizing hands in a healthcare setting. WHO also recommends following specific protocols before conducting a hand hygiene audit. Recommended guidance includes:

  • Inform staff about the audit before it happens. Hospital administrators and staff members should be notified in advance about the observation period and the purpose for performing the audit. Nurses and other healthcare workers should be provided with information about the documentation method being used for the audit. 
  • Identify audit areas. Hand hygiene audits are most effective when facilities pinpoint a specific area to monitor. 
  • Maintain patient privacy. Patients must never be compromised while conducting an audit.  Hospitals and other healthcare facilities may wish to obtain written permission from patients before auditing begins. Avoid auditing during situations like emergency medical treatment when patient care is the priority and permission likely cannot be obtained.  
  • Observe individual nurses and healthcare workers. When should hand hygiene be performed? WHO identifies what it calls the “Five Moments of Hand Hygiene.” They include:

1. Before touching a patient

2. Before cleaning and other aseptic procedures

3. After body fluid exposure or risk 

4. After touching a patient

5. After touching patient surroundings. 

Auditors can use Xapimed’s hand hygiene audit tool to track compliance.

  • Document and share findings. Arguably, the whole point of conducting a hand hygiene audit is to obtain key findings that will improve patient outcomes and reduce the spread of disease in the healthcare setting. Xapimed’s auditing software tool can take the data, analyze it, and compile it in a useful report for both the healthcare facility and the audited staff member. 

Xapimed’s multi-purpose auditing software

Xapimed’s multi-purpose auditing software provides actionable data on hand hygiene and many other procedures in any healthcare setting. Our auditing tool delivers reliable results to help hospitals and healthcare organizations craft protocols that improve patient outcomes. Contact our team today to learn more about how our technology can help your facility.

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