Susan George and Saloman Joseph collaborated in a nurse-led team on improving the organization's observations and compliance with hand washing. This program contributed to the hospital mission of providing outstanding care to the veteran population by assisting in the decrease of potential hospital-acquired infections. Ms. George and Mr. Joseph were role models for staff reading expansion and sustaining an improvement in several areas of the hospital, increasing the compliance and observation of handwashing in the hospital made a significant improvement in patient outcome by decreasing the potential for hospital-acquired infections.
They noted from the Inflection Control Prevention committee that hand hygiene compliance was poor with a 74% compliance rate throughout the organization. In addition, the tracer observation compliance was low because the tracers were not conducted systematically or scientifically. They identified that there was a staff knowledge deficit for hand hygiene compliance monitoring and performance.
They took the lead to improve the hand hygiene compliance for the organization. The goal was to change the culture for hand washing by introducing a new slogan "WASH" (what a simple habit). They developed a hand washing campaign that rapidly gained popularity in multiple nursing units in the hospital. They created a working group with the hand washing champions from each nursing unit to ensure 100% staff education and proper monitoring of hand washing compliance. After eight months of following the new hand washing process from CCU, MICU, SICU, PCU, 6S, 4S, SCI-V, and SCI-FV, they noted that hand washing compliance increased from 75% to 84%-94%. They ensured that TJC tracers/observations were documented accurately monthly by the hand washing champions from each nursing unit. Documentation improved to 100% compliance. They created and presented in-services to 300+ registered nurses to include day and night tours and the residents and fellows who round in the nursing units. They collaborated with nursing education to create a PowerPoint presentation on the "WASH" process and e-mailed the presentation to the nursing staff.
Their dedication and follow-up on this project was commendable and signifies the positive impact that staff nurse-led team can have on the culture/climate within the organization. Listed below are several outcomes from this nurse-led project.
-Recruited unit-based hand washing champions from each unit and educated them on the "WASH" campaign and slogan.
-Educated approximately 300 staff throughout the hospital in eight different unit in the hospital on the implementation and sustaining the WASH program. The presentation was commended by several Nurse Managers and an Assistant Chief.
-Implemented an education plan for nursing staff throughout the hospital regarding compliance with hand washing. A total of 15 hand washing champions were educated in the organization. This contributed to improved organization compliance in hand hygiene and was featured in the Nursing Shared Governance Newsletter.
-Designed and implemented a new hand washing reminder poster at each patient bed and ensured that the poster was placed in front of the patient's bed/room in all the acute care areas to include CCU, SICU, MICU, PCU, 6S, 4S, SCI-V, and SCI-FV.
-Developed the "WASH" card that was given to employees who are compliant with hand washing and are recognized by a peer for following the policy. When an employee receives a "WASH" card, they can place in a unit dropbox, and every month a card is selected for employee recognition as the hand washing champion of the month. Her process motivates the staff to be compliant with hand hygiene.
-They reviewed the hand washing observations from CCU, MICU, SICU, PCU, 6S, 4S, SCI-V, and SCI-FV. In addition, they followed up with the hand washing champions from above-mentioned units. Hand washing compliance increased from 75% to 84%- 94%. (up to a 22% improvement in compliance with hand washing throughout the hospital)
-This was instrumental in the Joint Commission resource tracers and observations being documented accurately monthly by the hand washing champions from each unit on the SharePoint. Successfully reported that the nursing documentation of handwashing monitors on the Joint Commission website has increased from minimal compliance to 100%.
-Presented the "WASH" program at the Hospital Patient Safety Awareness Celebration Week. The program was presented via poster, powerpoint, and demonstration via black light of proper hand washing and potential contamination from routine objects throughout the hospital i.e. staplers. The poster presentation was voted by attendees the second-place award for best presentation out of a total of 35 hospital submissions.
-The project has improved patient safety by decreasing hospital-acquired infections in the quest to achieve 5-star performance. This is evidenced by a decrease in CAUTI rates from 1.22 in 2016 to 1.035 in 2017 to and no open heart surgical site infections in the past year.
-The hand washing quality improvement project poster received best poster award out of 23 posters during the Hospital National Healthcare Quality Week. This was based on 184 participant feedback from various disciplines.
-The "WASH" campaign and results were published in an article, for the Nursing and Shared Governance Newsletter, 5th edition on the organizational process improvement project.
-The leadership demonstrated by the hand washing campaign was instrumental in improving the organization's nursing practice of hand washing with a subsequent improvement in organizational compliance. The compliance rate in the hospital improved from 75% to 84-94%. (up to a 22% increase in hand washing compliance throughout the hospital)
-Poster presentation of the "WASH" program was presented at the James a Haley Nursing Research and Evidence-Based Practice Conference.
-The impact of the campaign has resulted in the topic being added and presented by Ms. George and a peer to the to the New Employee orientation curriculum.
-The "WASH: "program has also been shared with staff in the Houston VA Hospital
-In addition, the organizational project contributed to improved staff morale in each unit because of the recognition received by staff for hand hygiene compliance.
-Based on the impact of this programs they are currently facilitators in the new employee orientation (NEO) program in JAHVAMC and educated the newly hired employees on the hand washing campaign.
-The "WASH" program has been submitted for potential presentation at the local American Association of Critical Care Nurses annual conference: Tides of Tampa Bay.