Background: Good hand hygiene is a crucial measure for preventing the spread of antimicrobial resistance and healthcare-associated infections (HCAIs). The factors contributing to the rise of HCAIs in patients with cancer may include an increase in antimicrobial resistance and the treatment effects of radiation and chemotherapeutic agents. Infection control and prevention practices such as proper hand hygiene practice could decrease infection rates among patients with cancer. Hence, in order to minimize cross-transmission of HCAIs, it is essential that healthcare providers working in the radiation therapy center practice proper hand hygiene technique.
Aims: This project aimed to improve adherence of hand hygiene practices among healthcare providers working in a radiation therapy center using the six steps hand hygiene techniques together with the “My five moments for hand hygiene” concept.
Methods: The team utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice program to conduct pre- and post-implementation audit using evidence-based criteria, and implement the change. The project was implemented from July 2011 to November 2011, in three different phases.
Results: The post-implementation results showed an improvement for all criteria except Criterion 5. Adherence rate for Criterion 2 showed a slight improvement of 28% (36% to 64%). There was a remarkable improvement of 73% (0 to 73%) in Criterion 3. Another remarkable improvement in adherence of 72% (10% to 82%) was observed for Criterion 4. Criterion 5 showed a 12% reduction in adherence (100% to 88%). Criteria 1 and 6 showed no change in adherence rate.
Conclusion: The improvement of adherence in five out of the six criteria in hand hygiene could be attributed to teamwork and dedication of the project team. The team had also gained knowledge and skills in enhancing their leadership roles in conducting this project. Sustaining the outcomes is an ongoing challenge, and the team had come up with different strategies to maintain the positive outcomes.
Senior Staff Nurse, Radiation Therapy Center, National University Cancer Institute Singapore, National University Health System (Chai)
Senior Nurse Clinician, Cancer Center, National University Cancer Institute Singapore, National University Health System (Chow)
Corresponding author: Chuen Fun Chai