Answering your questions about Hand Hygiene

What is hand hygiene?
Why are hand hygiene rates being publicly reported?
When should health care providers be cleaning their hands?
Which moments of hand hygiene are being publicly reported?

St. Joseph's Public Reporting

How are hand hygiene rates calculated?
Why is the Ministry reporting hand hygiene rates annually and not monthly or quarterly?
Do multi-site hospitals report hand hygiene compliance rates by corporation or by site?
What is the health care system doing with this information?
How frequently is St. Joseph's reporting this information?

Answering your questions about Hand Hygiene

What is hand hygiene?

Hand hygiene is the action of cleaning hands. There are two ways to clean hands. Using an alcohol based hand rub which kills organisms in seconds or, when hands are visibly soiled, using soap and running water.

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Why are hand hygiene rates being publicly reported?

The single most common way of transferring health care-associated infections (HAIs) in a health care setting is on the hands of health care providers. Health care providers move from patient to patient and room to room while providing care and working in the patient environment. This movement provides many opportunities for the transmission of organisms on hands that can cause infections. Monitoring hand hygiene practices is vital to improving rates and, in turn, reducing HAIs.

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When should health care providers be cleaning their hands?

There are four essential moments for hand hygiene:

• Before initial patient or patient environment contact
• Before aseptic procedure*
• After bodily fluid exposure risk
• After patient or patient environment contact

*An aseptic procedure could include: a) touching/manipulating a body site that should be protected against infections (e.g., wound care including dressing change and wound assessment); b) manipulating an invasive device that could result in infection of a body area (e.g. priming intravenous infusion set, inserting spike into opening of IV bag, flushing line, adjusting intravenous site, administering medication through IV port, changing IV tubing)

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Which moments of hand hygiene are being publicly reported?

The Ministry of Health and Long-Term Care (MOHLTC) will be reporting two of the moments : before initial contact with the patient/patient’s environment (moment 1) and after contact with the patient/patient’s environment (moment 4). The reason the Ministry is not reporting moments 2 and 3 (before aseptic procedures and after body fluid exposure risk) is because they occur much less commonly than moments 1 and 4 and because it is relatively difficult to observe enough of them to ensure a statistically valid sample size.

As of April 30, 2009, the Ministry reports the above data on its Patient Safety website. This data is updated annually.

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St. Joseph's Public Reporting

How are hand hygiene rates calculated?

Before Initial Patient/Patient Environment Contact:

# of times hand hygiene performed before initial patient/patient environment contact x 100 # observed hand hygiene indications before initial patient/patient environment contact

After Patient/Patient Environment Contact:

# of times hand hygiene performed after patient/patient environment contact x 100 # observed hand hygiene indications after patient/patient environment contact

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Why is the Ministry reporting hand hygiene rates annually and not monthly or quarterly?

Hand hygiene rates will be reported annually because behavioural and cultural change takes time. Therefore reporting hand hygiene rates more regularly than annually may not produce results that will indicate significant change or an impact on hand hygiene practices.

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Do multi-site hospitals report hand hygiene compliance rates by corporation or by site?

Hospitals that have multiple sites should be measuring, collecting, and reporting data for each site rather than providing an overall average for the corporation, as the rate can vary widely between sites. The MOHLTC website will report on hospitals by individual site.

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What is the health care system doing with this information?

Like the public reporting of other indicators, monitoring hand hygiene compliance rate is about overall performance improvement. The information gathered will assist hospitals in evaluating the effectiveness of their infection prevention and control interventions and make further improvements based on this information.

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How frequently is St. Joseph's reporting this information?

Hand Hygiene rates are posted on our website annually.

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Page last updated: April 30, 2010