New Hand Hygiene Initiative: Clean In, Clean Out

[hr]A study of the hand hygiene rates in some of Australia’s biggest hospitals has found patients could be routinely exposed to potentially deadly infectious bugs by doctors who are not following proper hygiene procedures, writes Narelle Shuh.[hr]
While nurses and other staff have shown drastic improvements in hand hygiene, doctors in particular are still lagging behind when it comes to the first, crucial moment of contact with a patient. NSW Health Minister, Jillian Skinner recently launched a program to specifically target doctors and other clinicians who are not following the rules. The Clean In, Clean Out initiative aims to improve hand hygiene which is currently the single most effective intervention to reduce the risk of hospital-acquired infections in NSW hospitals.
The Clinical Excellence Committee (CEC) campaign is focused on those doctors who make medical rounds of wards or undertake patient consultations, rather than surgical or trauma staff who must adhere to very strict hygiene protocols. CEC Chief Executive, Professor Cliff Hughes said clinical leaders have a vital role to play in preventing infection and the spread of disease in hospitals.
Posters featuring the tag line ‘Lead the Way: Be the First to Make a Difference’ have been designed for medical rounds where the evidence shows that if the first person approaching a patient follows good hand hygiene, the rest will follow. A new patient information pamphlet has also been developed to remind patients and their visitors that they can ensure
hand hygiene by using the wash basins and antiseptic gel dispensers which are widely available in hospitals.
The CEC currently supports and promotes the ‘Five Moments for Hand Hygiene’ developed by the WHO. The five moments are:

1. Before touching the patient.


2. Before performing an aseptic procedure.


3. After a procedure or a body fluid exposure risk.


4. After touching the patient.


5. After touching the patient’s surrounds.

A/Prof. Brian Owler said there had been some confusion among doctors about the five different ‘moments’ when they were supposed to use hand-cleaning products but that, “Things have been changing, with the change driven by younger doctors and medical students who know the value of hand hygiene. There is probably some cultural change needed among some of the older doctors but that really varies from hospital to hospital and doctor to doctor”.
This article was published in The NSW Doctor, AMA (NSW)