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Learning Objective 1: understand the obstacles in hand washing before and after changing wound dressing.
Learning Objective 2: understand the strategies to improve hand washing.
Methods: This was a quality improvement project. The first phase was to assess the reasons for not washing hands before and after changing wound dressing. The research team members observed physician, nurse practitioners, and staff nurses in a surgical unit when they performed wound change dressing two weeks period. The second phase was to formulate strategies to improve the hand washing rate. The third phase was to evaluate the effects of the strategies. Hand washing rates were calculated before and after implementing the strategies.
Results: Total of 150 persons were observed. Only 46% (n = 69) of them did wash their hands before and after changing wound dressing. Three major reasons were found, not touching the wound, wearing the glove may substitute hand washing, and time limitation. A changing dressing basket was designed to improve the hand washing rate. Besides, every computer screen was equipped with hand washing signs. After implementing the strategies, hand washing rate was improved as 85% (n = 162).
Conclusion: Unit specific hand washing strategies may improve the rate of hand washing before and after changing wound dressing.