‘Three Strikes’ Rule Boosts Hand Hygiene Compliance
‘Three Strikes’ Rule Boosts Hand Hygiene Compliance
As hospitals around the country stress hand washing as a means of reducing infection, a suburban Philadelphia medical center has kicked it up a notch.
In a new twist to the existing hand hygiene campaign at Abington Memorial Hospital, poor hand-washing habits now could cost staff their jobs. Those observed not washing their hands or using hand sanitizer when entering or leaving patient rooms will be handed index cards noting their noncompliance. After three infractions, offenders will receive a letter stating that their reappointment—which is required every two years to keep their jobs—is conditional.
Staff members observed adhering to protocol, however, may be given index cards making them eligible for a prize raffle.
“They’re really serious about [hand hygiene],” said Bob Spivak, RPh, a clinical staff pharmacist who has worked at the hospital for about 35 years. “They want everyone to comply.”
About two years ago, the hospital started a program in which employees serving as “spies” observed and reported how often doctors and nurses washed their hands or “gelled” (used hand sanitizer dispensers posted outside each patient room) when entering and leaving patient rooms. Initial surveys showed that the compliance rate was 31%. Soon after, the hospital began a major push to increase hand washing, including lecturing offenders and promoting hand hygiene through screensaver messages on every computer in the hospital.
As a result, the percentage of staff washing hands increased from 31% in December 2007 to 88% in September 2009. It has since leveled off at about 80%, according to a recent Philadelphia Inquirer article, although the aim of the three-card infraction program is to get hospital staff closer to 100%. Spies conduct between 800 and 1,400 observations each month.
A Downward Spiral
To make the message more personal, Abington’s chief of staff, John J. Kelly, MD, tells the story of patient Catherine
As hospitals around the country stress hand washing as a means of reducing infection, a suburban Philadelphia medical center has kicked it up a notch.
In a new twist to the existing hand hygiene campaign at Abington Memorial Hospital, poor hand-washing habits now could cost staff their jobs. Those observed not washing their hands or using hand sanitizer when entering or leaving patient rooms will be handed index cards noting their noncompliance. After three infractions, offenders will receive a letter stating that their reappointment—which is required every two years to keep their jobs—is conditional.
Staff members observed adhering to protocol, however, may be given index cards making them eligible for a prize raffle.
“They’re really serious about [hand hygiene],” said Bob Spivak, RPh, a clinical staff pharmacist who has worked at the hospital for about 35 years. “They want everyone to comply.”
About two years ago, the hospital started a program in which employees serving as “spies” observed and reported how often doctors and nurses washed their hands or “gelled” (used hand sanitizer dispensers posted outside each patient room) when entering and leaving patient rooms. Initial surveys showed that the compliance rate was 31%. Soon after, the hospital began a major push to increase hand washing, including lecturing offenders and promoting hand hygiene through screensaver messages on every computer in the hospital.
As a result, the percentage of staff washing hands increased from 31% in December 2007 to 88% in September 2009. It has since leveled off at about 80%, according to a recent Philadelphia Inquirer article, although the aim of the three-card infraction program is to get hospital staff closer to 100%. Spies conduct between 800 and 1,400 observations each month.
A Downward Spiral
To make the message more personal, Abington’s chief of staff, John J. Kelly, MD, tells the story of patient Catherine