Hand Hygiene Environment Toolkit – A Human-Factors Approach
Background
The Canadian Patient Safety Institute (CPSI) awarded the Healthcare Human Factors Group with the Hand Hygiene Environmental Assessment Project, a project aimed at gaining an understanding of the environmental precursors necessary to support an effective hand hygiene program and developing an assessment toolkit to complement CPSI’s national hand hygiene campaign – Stop! Clean Your Hands. The impetus for this project came from low healthcare worker hand hygiene compliance despite several international, national and provincial efforts.
Methods
A multi-phased user-centered approach was undertaken to explore barriers and enablers to hand hygiene in 4 diverse environments (rehabilitation and long-term care, family medicine, emergency and intensive care) for 5 healthcare workers (physicians, nurses, allied health, housekeeping, patient support workers). Observational studies, interviews with institutional leadership, focus groups, and surveys were used to engage users in environmental, product, and process solution development. Solutions were then validated through an environmental modification study, which sought to quantify the benefits of proposed solutions.
A multi-phased user-centered approach was undertaken to explore barriers and enablers to hand hygiene in 4 diverse environments (rehabilitation and long-term care, family medicine, emergency and intensive care) for 5 healthcare workers (physicians, nurses, allied health, housekeeping, patient support workers). Observational studies, interviews with institutional leadership, focus groups, and surveys were used to engage users in environmental, product, and process solution development. Solutions were then validated through an environmental modification study, which sought to quantify the benefits of proposed solutions.
Results
This research highlighted the need to take into consideration the differences between healthcare workers, their environments and the tools they are provided with when recommending solutions to barriers. Context-specific recommendations resulting from this work has been formulated into a toolkit for dissemination by CPSI in Summer 2009. The toolkit consists of a series of checklists and guides for conducting initial and ongoing assessments of healthcare environments, hand hygiene products, and supporting maintenance processes.
This research highlighted the need to take into consideration the differences between healthcare workers, their environments and the tools they are provided with when recommending solutions to barriers. Context-specific recommendations resulting from this work has been formulated into a toolkit for dissemination by CPSI in Summer 2009. The toolkit consists of a series of checklists and guides for conducting initial and ongoing assessments of healthcare environments, hand hygiene products, and supporting maintenance processes.