Hand Hygiene Times Newsletter - Knowledge Segment
Drive Hand Hygiene Compliance with Dispenser Placement
Jane Kirk MSN, RN, CIC, Clinical Specialist
During the past year The Joint Commission Center for Transforming Healthcare (JCCTF) began to address and find solutions for quality and safety problems in healthcare. Teaming with nationally recognized hospitals, they implemented the Robust Process Improvement TM (RPI) methods and tools such as Lean Six Sigma that other industries have been using for years to improve quality, safety and efficiency. Lean Six Sigma is a business management strategy that combines the principles of waste reduction with reducing variation, defects and mistakes.
One of the areas of focus with the JCCTF is hand hygiene. Through their studies in some of the nation’s leading hospitals and health systems – they were able to analyze specific breakdowns in hand hygiene compliance, discover the underlying causes and develop targeted solutions to this complex problem using quality improvement processes such as RPI and Lean Six Sigma.
| Issues Uncovered |
Solutions Implemented |
One of the problems was that the dispensers were not standardized or visible. |
The hospital changed so that all dispensers were the same and painted the wall behind them to make them more visible. |
Sometimes the dispensers were not filled. |
A process needs to be developed by the hospital to ensure that product is checked and replaced on a regularly scheduled basis. |
Another hospital learned that if you don’t make dispensers convenient to the healthcare worker, they will not go around the corner looking for a dispenser to clean their hands. |
One hospital studied the dispensers to determine if the dispensers were in the staffs’ workflow pattern. Hospital staff asked that there be dispenser placement between each patient room. Most hospitals found that healthcare workers want access to hand sanitizer more than just inside the patient room. |
As a result of this project, the Joint Commission standard for hand hygiene has changed. Previously, the standard called for hospitals to demonstrate hand hygiene compliance at a rate greater than 90%. A hospital that failed to comply would receive a Requirement for Improvement (RFI) and have 90 days to show improvement to 90% compliance. Now the standard states that hospitals need to work to improve compliance with process improvements.
In examining the main causes of healthcare worker failure to clean hands, one of the main root causes observed at the participating hospitals was ineffective placement of dispensers or sinks.1
In examining the problem of ineffective placement of dispensers or sinks, the participating hospitals discovered many challenges in this area. Hospitals determined many causes of the dispenser placement problem by interacting with patient care givers who offered solutions which could be applicable to any health
care setting.
This year of study of hand hygiene validated what has been stated previously by Infection Control thought leaders. Providing easy access to hand hygiene products in the correct delivery system can make a difference in hand hygiene compliance and staff and patient satisfaction.