Resident-Driven Quality Improvement Project in Perioperative Hand Hygiene
OBJECTIVESThe goal of the project was to improve hand hygiene compliance in the perioperative setting while involving anesthesia residents in quality improvement. To achieve this goal, we facilitated direct trainee participation on patient safety and quality improvement initiatives. The result was a...
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| Published in: | Journal of patient safety Vol. 15; no. 4; pp. e44 - e47 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
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01-12-2019
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| Abstract | OBJECTIVESThe goal of the project was to improve hand hygiene compliance in the perioperative setting while involving anesthesia residents in quality improvement. To achieve this goal, we facilitated direct trainee participation on patient safety and quality improvement initiatives. The result was a project for perioperative hand hygiene improvement conceived and led by anesthesiology residents.
METHODSAnesthesiology residents contributed project ideas and participated in problem-based learning discussions to develop several interventions for improving perioperative hand hygiene compliance. Interventions included electronic and laminated posters, reminder cards, monthly aggregated performance feedback, and a simulation-based hand hygiene workshop. Monthly hand hygiene compliance data were gathered during unannounced observations for a 29-month period. Run chart analysis and χ test were used to determine the impact of these interventions on compliance rates.
RESULTSA total of 1122 hand hygiene observations were made for 29 months. Run chart analysis showed a nonrandom shift and increasing trend during the postintervention period. The baseline hand hygiene rate was 68% (95% CI [65%–72%], n = 661), which increased to 79% post-intervention (95% CI [76%–83%], n = 461, P < 0.01).
CONCLUSIONSOur resident-led hand hygiene program used a multifaceted approach to drive sustained increases in perioperative hand hygiene compliance, while directly engaging house staff in quality improvement initiatives. |
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| AbstractList | OBJECTIVESThe goal of the project was to improve hand hygiene compliance in the perioperative setting while involving anesthesia residents in quality improvement. To achieve this goal, we facilitated direct trainee participation on patient safety and quality improvement initiatives. The result was a project for perioperative hand hygiene improvement conceived and led by anesthesiology residents.
METHODSAnesthesiology residents contributed project ideas and participated in problem-based learning discussions to develop several interventions for improving perioperative hand hygiene compliance. Interventions included electronic and laminated posters, reminder cards, monthly aggregated performance feedback, and a simulation-based hand hygiene workshop. Monthly hand hygiene compliance data were gathered during unannounced observations for a 29-month period. Run chart analysis and χ test were used to determine the impact of these interventions on compliance rates.
RESULTSA total of 1122 hand hygiene observations were made for 29 months. Run chart analysis showed a nonrandom shift and increasing trend during the postintervention period. The baseline hand hygiene rate was 68% (95% CI [65%–72%], n = 661), which increased to 79% post-intervention (95% CI [76%–83%], n = 461, P < 0.01).
CONCLUSIONSOur resident-led hand hygiene program used a multifaceted approach to drive sustained increases in perioperative hand hygiene compliance, while directly engaging house staff in quality improvement initiatives. OBJECTIVESThe goal of the project was to improve hand hygiene compliance in the perioperative setting while involving anesthesia residents in quality improvement. To achieve this goal, we facilitated direct trainee participation on patient safety and quality improvement initiatives. The result was a project for perioperative hand hygiene improvement conceived and led by anesthesiology residents. METHODSAnesthesiology residents contributed project ideas and participated in problem-based learning discussions to develop several interventions for improving perioperative hand hygiene compliance. Interventions included electronic and laminated posters, reminder cards, monthly aggregated performance feedback, and a simulation-based hand hygiene workshop. Monthly hand hygiene compliance data were gathered during unannounced observations for a 29-month period. Run chart analysis and χ test were used to determine the impact of these interventions on compliance rates. RESULTSA total of 1122 hand hygiene observations were made for 29 months. Run chart analysis showed a nonrandom shift and increasing trend during the postintervention period. The baseline hand hygiene rate was 68% (95% CI [65%-72%], n = 661), which increased to 79% post-intervention (95% CI [76%-83%], n = 461, P < 0.01). CONCLUSIONSOur resident-led hand hygiene program used a multifaceted approach to drive sustained increases in perioperative hand hygiene compliance, while directly engaging house staff in quality improvement initiatives. The goal of the project was to improve hand hygiene compliance in the perioperative setting while involving anesthesia residents in quality improvement. To achieve this goal, we facilitated direct trainee participation on patient safety and quality improvement initiatives. The result was a project for perioperative hand hygiene improvement conceived and led by anesthesiology residents. Anesthesiology residents contributed project ideas and participated in problem-based learning discussions to develop several interventions for improving perioperative hand hygiene compliance. Interventions included electronic and laminated posters, reminder cards, monthly aggregated performance feedback, and a simulation-based hand hygiene workshop. Monthly hand hygiene compliance data were gathered during unannounced observations for a 29-month period. Run chart analysis and χ test were used to determine the impact of these interventions on compliance rates. A total of 1122 hand hygiene observations were made for 29 months. Run chart analysis showed a nonrandom shift and increasing trend during the postintervention period. The baseline hand hygiene rate was 68% (95% CI [65%-72%], n = 661), which increased to 79% post-intervention (95% CI [76%-83%], n = 461, P < 0.01). Our resident-led hand hygiene program used a multifaceted approach to drive sustained increases in perioperative hand hygiene compliance, while directly engaging house staff in quality improvement initiatives. |
| Author | Feng, Aiden Yuzhe Piszcz, Regina Pimentel, Marc Philip T Urman, Richard D Lekowski, Robert W Nascimben, Luigino |
| AuthorAffiliation | Department of Infection Control, Brigham and Womenʼs Hospital, Boston, Massachusetts From the Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Womenʼs Hospital |
| AuthorAffiliation_xml | – name: From the Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Womenʼs Hospital – name: Department of Infection Control, Brigham and Womenʼs Hospital, Boston, Massachusetts |
| Author_xml | – sequence: 1 givenname: Marc Philip surname: Pimentel middlename: T fullname: Pimentel, Marc Philip T organization: From the Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Womenʼs Hospital – sequence: 2 givenname: Aiden surname: Feng middlename: Yuzhe fullname: Feng, Aiden Yuzhe organization: From the Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Womenʼs Hospital – sequence: 3 givenname: Regina surname: Piszcz fullname: Piszcz, Regina organization: Department of Infection Control, Brigham and Womenʼs Hospital, Boston, Massachusetts – sequence: 4 givenname: Richard surname: Urman middlename: D fullname: Urman, Richard D organization: From the Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Womenʼs Hospital – sequence: 5 givenname: Robert surname: Lekowski middlename: W fullname: Lekowski, Robert W organization: From the Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Womenʼs Hospital – sequence: 6 givenname: Luigino surname: Nascimben fullname: Nascimben, Luigino organization: From the Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Womenʼs Hospital |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30511824$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1001/archinte.159.8.821 10.1016/S0140-6736(00)02814-2 10.1016/j.ajic.2014.10.025 10.1056/NEJMsr1200117 10.1016/j.anclin.2010.11.003 10.1097/00000542-200309000-00006 10.1378/chest.120.6.2059 10.1086/650451 10.1016/j.ajic.2009.07.003 10.1053/jhin.2000.0882 10.1016/j.ajic.2011.10.008 10.1097/00000542-200309000-00002 10.1177/1062860610380731 |
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| SubjectTerms | Anesthesiologists Anesthesiology Cross Infection - prevention & control Feedback Guideline Adherence - standards Hand Disinfection - standards Hand Hygiene Humans Internship and Residency Perioperative Period Problem-Based Learning Quality Improvement Reminder Systems |
| Title | Resident-Driven Quality Improvement Project in Perioperative Hand Hygiene |
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