BSN Students Collaborate With Rural Community Hospital in Quality Improvement Project: Hand Hygiene Compliance

Purpose: The purpose of this descriptive study is 1) to determine if HCPs are consistently compliant with hand hygiene when caring for patients on multiple units and 2) to teach students the role and importance of QI in improving patient health outcomes. Involvement in inter-professional collaborative practice is believed to improve patient care and health outcomes (Hunt et al, 2018; Kanji, Lin & Krekoski, 2017). Healthcare associated infections (HAIs) provide a significant risk to patient health and safety outcomes. Worldwide, the most common mode of HAIs is contaminated hands and the single best method to prevent the spread of HAIs is hand hygiene (Haverstick et al, 2017). Every day one out of 25 patients in hospitals nationwide will contract a HAI (Magill et al, 2014). HAIs are a cause of increased rates of morbidity, mortality, disability, and rising costs for healthcare systems (Musu et al, 2017). Approximately 90,000 hospitalized patients will die from a HAI (Stone, 2014). To learn the importance of infection control and quality improvement (QI) in a hospital setting, senior level baccalaureate students will work collaboratively with a rural community hospital’s Quality Initiatives and Resources (QIR) Department to collect data on hand hygiene compliance. This proposed project will serve as the initial basis for future collaborative research and will provide data to help the QIR Department in determining the scope of the problem. This project will also allow students to learn valuable lessons in QI and inter-professional collaborative practice.

Methods: Senior baccalaureate nursing students enrolled in clinical courses, will collect data through direct observation of HCPs in an Emergency department, medical-surgical, telemetry, and intensive care unit as part of the QI project. Garcell et al (2017) noted that direct observation of hand hygiene is recommended by the World Health Organization to monitor hand hygiene compliance. Students will document hand hygiene compliance with a mobile device application called iScrub®. iScrub® is a free iPhone touch application that will allow students to efficiently record the type of HCP being observed and their hand hygiene compliance through standardized observations. Students will be trained on the use of the application and how to respond to any questions posed to them during an observation. Faculty will assign each student a specific date and unit during the course where they will observe HCPs entering and exiting patient care rooms. No names of HCPs or patient identification will be collected to maintain HIPPA. Students will rotate to different locations on each unit every hour over a six-hour period to ensure observations of an entire unit. Students will email collected data at the end of their observations to the Infection Control Coordinator who will input the data into a spreadsheet. Data will be collected during summer and fall 2019 semesters.

Results: Once the data collection is completed, data will be compiled and analyzed by the students and QIR department for each unit observed.

Conclusion: Based on the results, all will meet to collaborate on potential evidence-based practice solutions to aid in hand hygiene compliance.