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From Best Evidence to Best Practice – Implementation of a Hand Washing Campaign in the Accident and Emergency Department of the Georgetown Public Hospital Corporation

Objective: Hand washing compliance amongst emergency healthcare providers is complicated by limited supplies, patient volume, mal-positioning of hygiene materials, and lack of education on the importance of hand hygiene. 
Design and Methods: A survey was distributed to A&E healthcare staff to determine baseline knowledge about the importance of hand hygiene. Participants were asked to identify departmental obstacles to the practice of proper hand hygiene. Using World Health Organization teaching materials, a hand hygiene clinical observation tool was implemented to determine compliance prior to delivery of tailored education. Education was done utilizing posters, flyers, and powerpoint presentation. Hand sanitizer stations were installed to improve compliance. Finally, the clinical observation tool was implemented following the education initiative to determine impact on provider compliance. A post-implementation survey was distributed to determine if increased education and supplies impacted baseline knowledge and compliance. 
Results: Only 88% of surveyed providers recognized that the A&E has a current hand hygiene policy with 64% noting GPHC does not stress hand hygiene enough. Providers reported they utilize hand hygiene 75% yet all participants acknowledged that proper hand washing greatly reduces the spread of infection. 53% of providers surveyed felt comfortable encouraging their peers to wash their hands. 
Conclusions: Initial provider hand hygiene within the A&E was abysmal. Though identified as a predominant barrier, supplies were readily available throughout the observation window. Educational materials placed throughout the department improved both the perception and compliance of hand hygiene. The importance of provider hand hygiene must be continually stressed in order to maintain optimal compliance.