Improving Hand Hygiene Compliance in the Neonatal Intensive Care Unit at a Regional Children’s Hospital

Objective: Poor Hand Hygiene Compliance (HHC) among healthcare workers is directly associated with High Hospital Acquired Infections (HAI) worldwide. In 2011, the Centers for Disease Control and Prevention (CDC) reported 721,800 HAI per year in the United States among acute care hospitals along with 75,000 associated patient deaths. The objective of this quality improvement study was to evaluate the effect of hand hygiene educational interventions on HHC among Healthcare Workers (HCW) in a Neonatal Intensive Care Unit (NICU). Methods: This was a quality improvement project for increasing HHC at a tertiary care NICU using the Plan-Do-Study-Act design. This study was exempt from IRB review as it did not involve study subjects. The HCW staff included a comprehensive team of respiratory therapists, nurse practitioners, staff nurses, attending physicians, resident physicians, fellows, radiology technicians, child life staff, social workers, discharge planners, nutrition lab technicians, housekeeping staff, among others. The study consisted of recording HHC of HCW entering and leaving patient rooms before and after the educational intervention. The data collection instrument allowed recording of type of HCW, date, and HHC during day or night shifts. The instrument was completed by non-identified observers. No personal identifiers were collected in the study. The study implemented an educational intervention to all HCW based on CDC educational tools. Results: Surveillance included a total of 762 observations, 381 were pre-intervention and 381 post-interventions. Overall, HHC significantly increased from 110 (28.9%) pre-intervention, to 227 (59.6%) post-intervention (p-value: < .001). Post intervention increase in HHC was specifically noted in subgroups of physicians, respiratory therapists and registered nurses. Conclusion: HHC educational interventions among HCW in a tertiary care NICU are associated with significant improvement in HHC and may contribute to a decrease of HAI in the NICU.