Industry Voices—Pandemic lessons for creating a safer hospital environment for patients and staff

Care avoidance due to fear of exposure to COVID-19 poses a real and significant threat to hospital profitability—all while case counts continue to rise in the U.S. It has arguably never been more important to restore patient and staff confidence in the infection prevention measures put in place to keep everyone safe.

When COVID-19 hit, the infection prevention team at our 353-bed hospital and Level I trauma center assessed the emerging infection prevention needs related to the pandemic and identified a plan. For us, everything starts and ends with hand-washing. And, hand hygiene was cited, early on, by the Centers for Disease Control and Prevention and others as one of the single most important practices to reduce the spread of COVID-19.

It seems simple enough, but hand hygiene compliance has long been a challenge in the industry. Various studies over the years show that when staff are rushed and focused on imminent patient care needs, hand hygiene compliance can slip. While many hospitals believe they’re achieving 90% compliance, studies show average hand hygiene compliance is actually less than 40%.

That’s why we were reassured we had implemented an electronic hand hygiene compliance monitoring system hospitalwide just one year prior to COVID-19’s arrival in the U.S.—in February 2019. As a result of that implementation, we are confident we've achieved and sustained 90% hand hygiene compliance rates on an ongoing basis, and our rate of hospital-acquired infections dropped.

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What drives our success?

The system we use gives a gentle, real-time reminder when you haven’t washed your hands before approaching a patient—it pulls you back into the moment and keeps you compliant. The system allows continuous monitoring of the patient zone (a defined area around a patient bed, stretcher, infusion chair, etc.) and its interactions with individual healthcare workers—enabling access to accurate, actionable data to optimize the performance of individuals, units, departments and the overall hospital. Customizable digital dashboards log data and provide actionable insights, allowing our infection prevention team to pinpoint where corrective actions are needed.

Having the system in place allowed our infection prevention team to focus on other, emerging needs during COVID-19. It’s not a set it and forget it program, but it replaces a lot of labor time. It’s one less activity we have to directly have our hands on and worry about, which enables us to shift attention to education around masking, personal protective equipment practices and other essential work.

Our commitment to safety—for our team members, patients and community—continued as we faced the changing stages of COVID-19. We knew we needed to reassure our team and patients of the safety measures we had in place and those that were newly developed to keep each other safer. We developed a campaign called the Safer initiative, which highlights our key principles of masking, social distancing, hand hygiene and symptom screening—making them highly visible to staff, patients and visitors.

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As you enter our facilities, you’ll see large, brightly colored and engaging signage on the walls of every main entrance and elevator bank that serve as friendly reminders of the steps we’re taking to keep them safe. The Safer initiative is reinforced at touch points throughout their journey—where to sit in a lobby or stand in an elevator to accommodate social distancing, as well as reminders for safer meeting and break room practices.

Being accountable to simple precautions, like practicing hand hygiene, is the first line of defense in fighting against viral illness.

If everyone—both caregivers and members of the general public—can continue to be as diligent about hand-washing as we were at the start of the pandemic, it could have an enormously positive impact on lowering the transmission of illnesses. Reminders—from a badge beep for staff in our hospital rooms to a sign on a visitor elevator—can go a long way in saving lives.

Molly Reagan is the interim vice president/chief nursing officer at North Memorial Health in Robbinsdale, Minnesota. She has previously served as the director of patient care and was instrumental in the successful rollout of the Ecolab Hand Hygiene Compliance Monitoring System.