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INF ECTION P R EVENTION


Step 1


l System change l Training and education l Evaluation and feedback l Reminders in the workplace l Institutional safety climate


Implementation of such a programme over two years has been shown to result in a change in the culture of a hospital, where compliance rates increased from 41% to 87%, with associated reductions in infections from 4.8 to 3.3 per 1000 inpatient days.3 Ecolab has successfully implemented such a programme driving improvements in hand hygiene compliance at many healthcare facilities worldwide, with sustained performance over many years. This is the ultimate goal; short-term improvements can more easily be achieved but sustaining results is key to ensuring the programme of improvement has real impact. The right access to the right products combined with a strong hand hygiene culture can have long- term benefits to the operations of a hospital. A recent case study from the Provincial


Polyclinic Hospital in Toruń, Poland4 has demonstrated just that; a significant improvement (46%) in hand hygiene compliance six years after implementation of Ecolab’s comprehensive hand hygiene programme, following the WHO multi-modal strategy.


A systematic tool, the WHO Hand Hygiene Self-Assessment Framework (SAF), was used to analyse promotion of hand hygiene and practices within the hospital, assessing existing resources and identifying areas for improvement. It also acted as a catalyst for implementing and sustaining the hand hygiene programme. In 2019, the hospital reported a SAF score which improved by 86% in the six years following implementation. An additional significant improvement was also


Step 2


identified following a review of all infections caused by alert pathogens. Between 2015 and 2019, the total number of infections, both healthcare and community associated, reduced by 11%, with healthcare-associated infection alone decreasing by 33%. In addition to the metrics described,


a survey of staff within the hospital demonstrated that the programme has successfully embedded a culture of engagement where staff have a greater understanding of the role of hand hygiene in reducing healthcare-associated infections and individual responsibility in ensuring high standards of hand hygiene practises. Katarzyna Mikowska, lead for the infection control and hygiene department, at the Provincial Polyclinic Hospital, Toruń, has highlighted the impact of the hand hygiene programme for her facility: “As a result of the implementation of the WHO Multi-Modal Strategy, the Provincial Polyclinic Hospital


46 l WWW.CLINICALSERVICESJOURNAL.COM


in Toruń saw a marked improvement in the assessment of hand hygiene and the action undertaken resulted in declining numbers of healthcare-associated infections at the facility. These results were made possible through multi-year cooperation with Ecolab, who supported the hospital with hand hygiene training for different personnel groups and assisted with the processing of observation results.” An integral part of the Ecolab’s hand hygiene programme is providing hand hygiene products at the point of care. Soaps and alcohol-based hand rubs (ABHRs) are provided in key locations where they can be used at the right place, at the right time. Balanced solutions that ensure effective performance, combined with skin-friendly ingredients that moisturise and protect skin should be sought in order to have the greatest impact on compliance and therefore successful outcomes for patients.


JANUARY 2021


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