CONCLUSION
Monitoring hand hygiene, like other forms of surveillance, can
be helpful to improve patient outcomes; but, without appropriate
use of the data, it is a waste of valuable resources and could even
potentially do harm. Short-term “fixes” have not been successful to
improve staff practices; clearly, a more informed approach that
includes an understanding of behavior change is required. Based
on what has been successful to date, the following strategies are
recommended:
? Cease from using enforcement strategies that create frustration
in infection prevention staff and irritation in clinical staff, get
out of a we/they mentality;
? develop an understanding of what motivates behavior change
and the patience to plan strategically and for the long term;
? help administrators who seek immediate results to understand
the above;
? engage clinical staff to determine what they find meaningful
and how to develop multiple long-term strategies that are
sustainable; and
? apply the actionable feedback model to assure that feedback
and interactions regarding hand hygiene are timely, nonpunitive,
individualized, and customizable.
Without a change in how hand hygiene data are used, the
vicious cycle of “we” (infection prevention staff) versus “them”
(clinicians) will continue. As noted by Sepkowitz, “. . . we should
embrace the intellectual audacity of our beloved Semmelweis but
let go of his how-to manual