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Hand hygiene

2011 Asia Pacific Hand Hygiene Excellence Award Winner National Taiwan University Hospital

Adherence to good hand hygiene (HH) practices is the cornerstone for preventing healthcare-associated infections (HAI). Through sustained efforts and performance of annual HH program since 2004 National Taiwan University Hospital (NTUH) was accredited of "2011 Asia Pacific Hand Hygiene Excellence Award" among 108 hospitals in this region. This experience may apply to other measures for patient safety and combating antimicrobial resistance.

Adherence to good hand hygiene (HH) practices is the cornerstone for preventing healthcare-associated infections (HAI).

Implementation of a hand hygiene program reduces preventable healthcare-associated infections and is cost effective

We observed 8,420 opportunities for HH during April 2004 to Dec 2007.

Through sustained efforts and performance of annual HH program since 2004 National Taiwan University Hospital (NTUH) Hospital-wide HH program, with particular emphasis on using an alcohol-based hand rub, was implemented in April 2004 at NTUH. We observed 8,420 opportunities for HH during April 2004 to Dec 2007. Compliance (before and after patient contact) improved from 43.3% in April 2004 to 95.6% in 2007, and was closely correlated with increased consumption of the alcohol-based hand rub. The disease severity score (Charlson comorbidity index) increased during the intervention period. Nevertheless, we observed an 8.9% decrease in HAIs and a decline in the occurrence of bloodstream, methicillin-resistant Staphylococcus aureus, extensively drug-resistant Acinetobacter baumannii, and intensive care unit infections. The net benefit of the HHP was US$5,289,364, and the benefit-cost ratio was 23.7 with a 3% discount rate.

Compliance improved from 43.3% in April 2004 to 95.6% in 2007

 

Starting small and using smart strategy with incremental target since 2004 and leading other hospitals in Taiwan to adapt the WHO multimodal strategies in 2009

Compliance improved from 43.3% in April 2004 to 95.6% in 2007-1

  Key success factors include the continuation of support from superintendents (photo showed E-letter from superintendent to every staff), and team works. We provide alcohol-based hand rub hospital-wide (particularly at the point of care) and balance between accessibility versus fire safety and patient safety. We customize "My Five Moments" and put posters or reminders at the healthcare zone as well as at the public area. We have annual hospital-level lectures for staff. We also encouraged HH ambassadors (role model nearby) to conduct unit-level quality improvement program, provide skill-based education and accreditation.

NTUH, one of three Centers of Excellence for Hand Hygiene Promotion in Taiwan, has shared experiences with others via lectures, workshops and Patient Safety Summit in a 2-year country-wide HH accreditation program. Superintendents from different hospitals showed their commitment (photo). We emphasize the importance of top-down leadership and bottom-up efforts to achieve the institutional safety climate.

Poster 1   Poster 2   Poster 3   Poster 4

 


World Hand Hygiene Day: increase the awareness of the public

The government and hospitals show their commitment.

The Key   Opening Events   Hand protection 100 healthy 55
(Photo. 2010 from left, Deputy Director of Department of Health, Superintendent of NTUH, Lady of the Vice President, Taiwan; 2011 from left, Director of Taipei City Health Agency, General Director of CDC, Superintendent and Vice Superintendents of NTUH).

We design a series of activities to increase in the awareness of the public through the media and the web, and the engagement of the activity on World Hand Hygiene Day activity (poster and logo design, song and dancing, and "To see is to believe" game).

Opening Events 2   Poster 6   Poster 7   Poster 8

Children participate photo

Events Photos 1   Events Photos 2

 

We also design a Kung-Fu based slogan in conjunction with UV detection system to improve HH technique and facilitate behavior change.

Events Photos 3   Events Photos 3-1

 


5C: Care, Cooperation, Creativity, Consistency and Continuation

It is challenging how to further improve the HH compliance rate. Last year we emphasized (1) integrate HH into workflow and avoid unnecessary HH; (2) optimization of procedures to decrease HH opportunities; (3) taking care of hand skin by proper use of hand lotion; (4) appropriate selection of HH methods, more alcohol-based hand rub, and less hand washing.

 

To See Is To Believe

Hidden Danger! You wash your hands yet?

A stress-free, "to see is to believe" program was designed for the public on May 5, 2011 and implemented for staff in May 2012. The visitors attending World Hand Hygiene Day activity and our staff enjoyed this activity very much. Thus we applied this activity to promote HH awareness and skills in senior high schools, kindergartens, patient and their family.

Events Photos 5   Lianxiangxiyu

 


From Hospital To Community

Web page picture

Events Photos 6-11   

 

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