One hospital says the best way to promote hand hygiene is to empower nurses to speak up—even if that means critiquing the CNO, Shannon Barnet reports for Becker's Infection Control and Clinical Quality.
Internal survey data at Mayo Clinic Florida (MCF) show that compliance with hygiene policies in recent years has hovered between 95% and 100%. The consistent high performance can make a real difference for patients who are vulnerable to hospital-acquired infections.
To achieve such strong performance, MCF has put in place several initiatives that leverage nurses to strengthen hand-hygiene best practices. Nurses, CNO Deb Harrison says, are critical because they are natural patient advocates and consistently are "working at the point of care."
MCF asks nurses to educate patients on hand hygiene best practices and to show patients the location of disinfectant wipes in their room. Nurses then ask patients to fill out questionnaires on how well their providers comply with hygiene practices.
The survey data are reported on a quarterly basis and help administrators monitor performance. The regular reminders also serve to keep hygiene best practices fresh in the minds of clinicians.
MCF also has worked through its "Commitment to Safety" program to empower nurses to speak up when they observe staffers engaging in incorrect hand hygiene. For instance, nurses are trained to use a special phrase—"I need a little clarity"—when they see someone skip an "important infection prevention step," Harrison says.
The phrase is a way to institutionalize speaking up and avoid having a confrontation in front of patients. Harrison explains that nurses are trained to speak up even when the offending individual is more senior.
Harrison recalls one nurse who recently reminded her to wash her hands before seeing a patient in protective isolation. "I thought it was great that the nurses had no problem speaking up to the CNO," she says (Barnet, Becker's Infection Control and Clinical Quality, 2/10).
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