HAND HYGIENE OBSERVATION DATA

+----------------------+--------+--------+--------+--------+--------+
|                      | **MI   | **SI   | **I    | **I    | **T    |
|                      | CU-1** | CU-1** | CU-2** | CU-3** | otal** |
+----------------------+--------+--------+--------+--------+--------+
| **Baseline           | 509    | 511    | 407    | 911    | 2338   |
| observations**       |        |        |        |        |        |
+----------------------+--------+--------+--------+--------+--------+
| **Baseline percent   | 51%    | 51%    | 52%    | 39%    | 47%    |
| Yes**                |        |        |        |        |        |
+----------------------+--------+--------+--------+--------+--------+
| **Time of Initial    | Oct    | J      | Jan    | Jan    | NA     |
| observations**       | 2003   | an/Feb | 2004   | 2004   |        |
|                      |        | 2004   |        |        |        |
+----------------------+--------+--------+--------+--------+--------+
| **Final              | 338    | 320    | 405    | 699    | 1762   |
| observations**       |        |        |        |        |        |
+----------------------+--------+--------+--------+--------+--------+
| **Final percent      | 79%    | 87%    | 83%    | 76%    | 80%    |
| Yes**                |        |        |        |        |        |
|                      | P\     | P\     | P\     | P\     | P\     |
|                      | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 |
+----------------------+--------+--------+--------+--------+--------+
| **Time of Final      | May    | May    | Apr    | May    | NA     |
| observations**       | 2004   | 2004   | il/May | 2004   |        |
|                      |        |        | 2004   |        |        |
+----------------------+--------+--------+--------+--------+--------+
| **Percent            | 55%    | 71%    | 60%    | 95%    | 72%    |
| Improvement in       |        |        |        |        |        |
| Compliance**         |        |        |        |        |        |
+----------------------+--------+--------+--------+--------+--------+

Table OB1: Observed Compliance, by ICU and overall

![](media/image1.wmf){width="6.0in" height="3.4791666666666665in"}

Figure OB1: Observed hand hygiene compliance, by ICU and overall for all
four ICUs

![](media/image2.wmf){width="6.252777777777778in"
height="4.252777777777778in"}

Figure OB2: Observed hand hygiene compliance, by practice measured in
observation tool. Observed Practices were as follows (see Figure 2 for
additional information):

1)  Before clean and aseptic procedures, including medication prep and
    prior to prep, gown & glove for sterile procedures.

2)  After contact with blood, body fluids, secretions or excretions,
    mucous membranes, non-intact skin.

3)  After handling objects and devices such as soiled linen, trash,
    equipment.

4)  After removing gloves or other PPE used for contact with body
    substances.

5)  Before patient contact.

6)  After patient contact upon exiting patient's room.

7)  Upon entering patient's room before equipment contact.

8)  After equipment contact upon exiting patient's room.

+--------------------+---------+----------+---------+----------------+
| > **Baseline       |         |          |         |                |
| > Data**           |         |          |         |                |
+--------------------+---------+----------+---------+----------------+
| > **HCW category** | >       | > **No** | > **    | > **Yes        |
|                    | **Yes** |          | Total** | > Percent**    |
+--------------------+---------+----------+---------+----------------+
| > **RN**           | > 604   | > 526    | > 1130  | > 53%          |
+--------------------+---------+----------+---------+----------------+
| > **MD**           | > 146   | > 165    | > 311   | > 47%          |
+--------------------+---------+----------+---------+----------------+
| > **Other**        | > 346   | > 551    | > 897   | > 39%          |
+--------------------+---------+----------+---------+----------------+
| > **Totals**       | > 1096  | > 1242   | > 2338  | > 47%          |
+--------------------+---------+----------+---------+----------------+
| > **Final Data**   |         |          |         |                |
+--------------------+---------+----------+---------+----------------+
| > **HCW category** | >       | > **No** | > **    | > **Yes        |
|                    | **Yes** |          | Total** | > Percent**    |
+--------------------+---------+----------+---------+----------------+
| > **RN**           | > 709   | > 155    | > 864   | > 82%          |
+--------------------+---------+----------+---------+----------------+
| > **MD**           | > 144   | > 43     | > 187   | > 77%          |
+--------------------+---------+----------+---------+----------------+
| > **Other**        | > 556   | > 155    | > 711   | > 78%          |
+--------------------+---------+----------+---------+----------------+
| > **Totals**       | > 1409  | > 353    | > 1762  | > 80%          |
+--------------------+---------+----------+---------+----------------+

Table OB2: Baseline and final observed compliance for RNs, MDs, and
Others

![](media/image3.wmf){width="6.000694444444444in" height="3.69375in"}

Figure OB3: Baseline and final observed compliance for RNs, MDs, and
Others

HAND HYGIENE QUESTIONNAIRE DATA

+--------------------+-------------------+-------------------+---------+
| **Question**       | **Initial Data    | **Final Data      | **P-    |
|                    | (104)**           | (77)**            | value** |
+--------------------+-------------------+-------------------+---------+
| Is there a         | 90.4%             | 93.5%             | 0.166   |
| protocol?          |                   |                   |         |
+--------------------+-------------------+-------------------+---------+
| Self-compliance    | 87.8% (n=96)      | 86.5% (n=73)      | 0.207   |
| rate estimate      |                   |                   |         |
+--------------------+-------------------+-------------------+---------+
| **Hand             |                   |                   |         |
| Self-Assessment**  |                   |                   |         |
+--------------------+-------------------+-------------------+---------+
| Appearance (1-7)   | 5.5               | 5.8               | 0.269   |
+--------------------+-------------------+-------------------+---------+
| Intactness (1-7)   | 5.2               | 5.5               | 0.267   |
+--------------------+-------------------+-------------------+---------+
| Moisture (1-7)     | 4.3               | 4.6               | 0.334   |
+--------------------+-------------------+-------------------+---------+
| Sensation (1-7)    | 5.2               | 5.6               | 0.145   |
+--------------------+-------------------+-------------------+---------+
| **Hand Hygiene     | ** **             | ** **             |         |
| Motivators**       |                   |                   |         |
+--------------------+-------------------+-------------------+---------+
| Relationship?      | 4.8               | 4.9               | 0.133   |
| (1-5)              |                   |                   |         |
+--------------------+-------------------+-------------------+---------+
| Colleague reminds  | 2.1               | 2.1               | 1.0     |
| (1-5)              |                   |                   |         |
+--------------------+-------------------+-------------------+---------+
| Remind others      | 2.8               | 2.9               | 0.661   |
| (1-5)              |                   |                   |         |
+--------------------+-------------------+-------------------+---------+
| Patient reminds    | 1.2               | 1.2               | 1.0     |
| (1-5)              |                   |                   |         |
+--------------------+-------------------+-------------------+---------+
| **Products Used**  |                   |                   |         |
+--------------------+-------------------+-------------------+---------+
| Soap and water (%) | 56.3              | 49.0              | 0.124   |
+--------------------+-------------------+-------------------+---------+
| Alcohol alone (%)  | 39.1              | 52.4              | 0.002   |
+--------------------+-------------------+-------------------+---------+
| **Satisfaction?**  |                   |                   |         |
+--------------------+-------------------+-------------------+---------+
| Satisfaction       | 4.0               | 4.3               | 0.065   |
| practices (1-5)    |                   |                   |         |
+--------------------+-------------------+-------------------+---------+
| Satisfaction       | 4.0               | 4.5               | 0.003   |
| products (1-5)     |                   |                   |         |
+--------------------+-------------------+-------------------+---------+
| Job Function       | RN - 45 (43%)     | RN - 36 (47%)     |         |
| Summary            |                   |                   |         |
|                    | MD - 6 (6%)       | MD - 8 (10%)      |         |
|                    |                   |                   |         |
|                    | Other - 51 (49%)  | Other - 31 (40%)  |         |
|                    |                   |                   |         |
|                    | Blank - 2 (2%)    | Blank - 2 (3%)    |         |
|                    |                   |                   |         |
+--------------------+-------------------+-------------------+---------+

Table Q1: Baseline and final responses to hand hygiene questionnaire

![](media/image4.wmf){width="6.000694444444444in"
height="3.3881944444444443in"}

Figure Q1: Self-reported compliance with required hand hygiene
practices, baseline and final

  --------------------------------------- --------------- ----------------
  **Reasons Given for not Practicing Hand **Baseline      **Final Reason**
  Hygiene as Required**                   Reason**        

  **Too Busy**                            46              27

  **Forget**                              29              36

  **Not in convenient location**          12              4

  **Damages Skin**                        10              7

  **Out of product**                      8               5

  **Unsure of Need**                      5               3

  **Always wear gloves**                  3               0

  **Emergency**                           2               2

  **Total**                               113             82
  --------------------------------------- --------------- ----------------

Table Q2: Baseline and final reasons reported for not practicing hand
hygiene

![](media/image5.wmf){width="6.246527777777778in"
height="3.2916666666666665in"}

Figure Q2: Self-reported reasons for non-compliance, baseline and final.

[HAND HYGIENE: ALCOHOL-BASED HAND RUB (QUANTITY) USE DATA]{.underline}

  ---------------- -------------------- ------------------- -------------------
  ** **            **MICU-1 g per 100   **SICU-1 g per 100  **ICU-2 g per 100
                   pt-days**            pt-days**           pt-days**

  **Baseline                                                
  Data**                                                    

  **Jul-03**       1970                 1178                

  **Aug-03**       1860                 1179                

  **Sep-03**       1845                 688                 

  **Oct-03**       966                  893                 

  **Nov-03**                            1029                

  **Dec-03**                            846                 

  **Jan-04**                                                907

  **Intervention                                            
  Data**                                                    

  **Nov-03**       2955                                     

  **Dec-03**       3320                                     

  **Jan-04**       2878                 1883                

  **Feb-04**       3334                 1900                1309

  **Mar-04**       2845                 1814                1301

  **Apr-04**       4783                 1854                1511

  **May-04**       3549                 2285                1571

  **Jun-04**       3389                 1625                1623

  **Jul-04**       3066                 1877                1627

  **Aug-04**       2383                 1910                1623

  **Sep-04**       3431                 1800                1800
  ---------------- -------------------- ------------------- -------------------

Table G1: Grams of alcohol-based hand rub used per 100 patient-days per
month at MICU-1, SICU-1, ICU-2. Data from ICU-3 was not able to be used
in project.

  ------------- ------------------- -------------------- -------------------
  ** **         **MICU-1 g per 100  **SICU-1 g per 100   **ICU-2 g per 100
                pt-days**           pt-days**            pt-days**

  **Mean of     1660                969                  907
  Baseline                                               
  Data**                                                 

  **Mean of     3267                1883                 1546
  Final Data**                                           

  **Percent     97%                 94%                  70%
  Increase**                                             

  **P-value**   P=0.001             P\<0.001             N/A
  ------------- ------------------- -------------------- -------------------

Table G2: Mean baseline and final alcohol-based hand rub used per 100
patient-days per month at MICU-1, SICU-1, ICU-2.

![](media/image6.wmf){width="6.497222222222222in" height="3.8125in"}

Figure G1: Alcohol-based handrub used per 100 patient-days. MICU-1:
Intervention period started November 2003, SICU-1: Intervention period
started January 2004, and ICU-2: Intervention period started February
2004

![](media/image7.wmf)![](media/image8.wmf)![](media/image9.wmf)

Figure G2: Control Chart showing baseline and final grams of
alcohol-based hand rub used per 100 pt-days per month for MICU-1, SICU-1
and SICU-2