HELP US TO PREVENT INFECTIONS SPREADING cleanyourhands campaign YEAR THREE

Why the need for a hand hygiene campaign?

HCAI: a global problem At any time, over 1.4 million people worldwide suffer from infections associated with healthcare In developed countries about 5-10% of patients admitted to acute care hospitals acquire an infection* *Tikhomirov E. WHO Programme for the control of hospital infections

HCAI: England and Wales It is estimated that 8% of adult hospital patients in England have a HCAI at any one time* Just over 6% of patients admitted to hospital in Wales acquire an infection* In England HCAIs are estimated to cause the deaths of at least 5000 patients every year and cost the NHS £1 billion* This equates to an infection of a patient every two minutes and the death of a patient every two hours*** * The Third National Prevalence Survey of Healthcare Associated Infections in Acute Hospitals, UK & Republic of Ireland 2006 ** The Management and Control of Hospital Acquired Infection in NHS Acute Trusts in England, The National Audit Office 2000 *** The Chief Medical Officer for England’s Annual Report 2006

Infection is a patient safety problem 1 3 of HCAIs are estimated to be easily preventable* *Action on Health Care Associated Infections in England, Department of Health Consultation document 2005

The answer is in your hands.

The role of hands Hands are the main way in which infection is spread so when you clean your hands before and after every patient contact it helps to stop the bugs spreading YET most healthcare workers clean their hands less than half the number of times they should* * WHO Guidelines on Hand Hygiene in Health Care

What is the cleanyourhands campaign?

The cleanyourhands campaign aims to improve the hand hygiene of healthcare workers to prevent the spread of infection and help the NHS tackle HCAI. Following a pilot in 2003, the campaign was rolled out nationally from 2004. All acute trusts in England and Wales have now signed up to the campaign. The campaign is now entering its third year in hospitals.

The campaign toolkit Alcohol handrub to enable healthcare workers to clean their hands at the point of care, quickly and effectively. Prompts and other materials to remind staff to clean their hands. Involving patients in improving hand hygiene. Tools and resources that support campaign co-ordinators to engage staff at all levels of their organisation.

Evaluating its effectiveness An independent programme of ongoing research* has found that already: The campaign has changed many aspects of hand hygiene behaviour in hospitals. The number of times that healthcare workers clean their hands per patient per day has increased from six to 16 All hospitals have alcohol handrub in more than three quarters of their wards 80% of hospitals have the campaign posters in more than three quarters of their wards *The National Observational Study to Evaluate the cleanyourhands Campaign (NOSEC) Further information available from: www.idrn.org/nosec.php

Year Three of the campaign

Researching the approach The NPSA carried out extensive consultation with healthcare staff across the NHS in England and Wales including: Survey of 300+ healthcare workers about their routines and behaviours regarding hand hygiene Focus groups with medical and nursing staff as well as patients Visual audits of a number of hospitals

Research findings: There is no one clear procedure for hand hygiene practice that is understood by NHS staff Only 55% said that they routinely clean their hands before and after treating every patient. 78% of respondents were aware of the existing cleanyourhands campaign, but 50% felt more should be done to get the messages across. Respondents felt that the campaign’s effectiveness could be improved by ‘more training’ and a ‘harder-hitting campaign’

This year: There is a harder-hitting campaign More educational information has been incorporated Materials have been designed to standout in hospital environments Wider range of materials, for example, signage to highlight locations of alcohol handrub dispensers and others to showcase local champions and achievements

Year Three Eight posters will be sent out over the year in two stages. The first stage posters stay in place for the duration of Year Three. The second stage refreshes and complements, rather than replacing the first. Posters will no longer need to be changed monthly, removing the burden from staff of changing materials frequently.

Among the eight posters there are two in a larger A2 format Among the eight posters there are two in a larger A2 format. These convey the key messages of the campaign and stand out from other materials.

Directional signage to highlight alcohol handrubs. Can also be used by sinks. Contain educational information to reinforce hand hygiene practice.

Multipurpose panel for attaching to PCs, telephones and even hand dryers. Aims to get target staff when not expecting it and may be receptive to more detailed information e.g. when at phone responding to a bleep.

Point of care prompts to remind staff to clean their hands at the point of care. Repositionable low tack sticker.

Champion standee works as both a poster and a freestanding desk item. Highlights local hand hygiene champions and creates positive role models.

Spotlight poster can be used to highlight local initiatives and information.

Involving patients Poster specifically aimed at patients aims to raise awareness among patients of importance of hand hygiene and make them feel comfortable asking if they think staff have forgotten to clean their hands.

Updated and simplified patient leaflet.

The staff leaflet provides information on how and when to clean hands.

What next?

Future development: Planning for the fourth year of the campaign – more emphasis on education and learning Extending the campaign to primary care, mental health, ambulance and care trusts as well as care homes and hospices – the campaign is being piloted before being rolled out nationwide in England and Wales.

Scoping work has been undertaken with a view to extending the campaign to general practice - the campaign will be tested in Wales and one English region initially, before being rolled out to the rest of England. Strengthening patient involvement in the campaign with a pilot scheme announced in the CMO for England’s annual report 2006 where patients are given alcohol handrub on admission to hospital.

Any questions?