3 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. ** HCAI: a global problem
4 HCAI: England and Wales It is estimated that 8% of adult hospital patients in England have a healthcare associated infection (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 5,000 patients and cost the NHS £1 billion*** every year. This equates to an infection of a patient every two minutes and the death of a patient every two hours.***
5 Infection is a patient safety problem 1313 of HCAIs are estimated to be easily preventable*
7 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.*
9 Following an NPSA pilot in 2003, the campaign was rolled out in England and Wales 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 in England and Wales. The DHSSPS is now building on that experience and introducing the campaign in Northern Ireland. The cleanyourhands campaign aims to improve the hand hygiene of healthcare workers to prevent the spread of infection and help HSC bodies tackle HCAI.
10 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 infection control leads to engage staff at all levels of their organisation.
11 Evaluating its effectiveness An independent programme of ongoing research conducted by the National Observational Study to Evaluate the cleanyourhands Campaign (NOSEC) has found that in England and Wales: 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.
13 Researching the approach a 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. The NPSA carried out extensive consultation with healthcare staff across the NHS in England and Wales including:
14 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 that more should be done to get the messages across. Respondents felt that the campaigns effectiveness could be improved by more training and a harder-hitting campaign.
15 The campaign This is a harder-hitting campaign. Educational information has been incorporated. Materials have been designed to stand out in hospital environments. There is a wider range of materials, for example signage to highlight locations of alcohol handrub dispensers including a poster to showcase achievements
16 The campaign Eight posters will be sent out over the year in two stages. The first stage posters stay in place for the duration of the year. The second stage refreshes and complements, rather than replacing the first.
17 Among the eight posters are two in a larger A2 format. These convey the key messages of the campaign and stand out from other materials.
18 Directional signage is used to highlight alcohol handrub dispensers. It can also be used by sinks. It contains educational information to reinforce hand hygiene practice.
19 The multipurpose panel is for attaching to PCs, telephones and even hand dryers. It aims to target staff when they are not expecting it and may be receptive to more detailed information, e.g. when at a phone responding to a bleep.
20 Point of care prompts remind staff to clean their hands at the point of care. They are repositionable low-tack stickers.
21 The spotlight poster can be used to highlight local initiatives and information.
22 Involving patients This poster specifically aimed at patients aims to raise awareness among patients of the importance of hand hygiene and make them feel comfortable asking if they think that staff have forgotten to clean their hands.