The ABCs of Hand Hygiene: B is for Busyness

By Chris Hermann

Why don’t healthcare providers clean their hands every time they should? In our experience, it comes down to the “ABCs”:

  • Awareness
  • Busyness
  • Craziness

We covered Awareness last week and will discuss Busyness today. Simply put, the busier a clinician is, the more difficult it is for them to maintain a high hand hygiene performance rate. It makes sense, right? Someone moving at a more leisurely pace has plenty of time as well as the focus to remember to clean their hands every time they enter and exit a patient’s room. But another provider who’s running from room to room has so much on their mind and they’re moving so fast that they’re more likely to forget to sanitize.

The graph below shows about 90 million hand hygiene performance data points that we’ve gathered. Each dot represents one provider’s hand hygiene performance for one week. The Y axis shows average performance – obviously, higher is better. The X axis shows the number of weekly hand hygiene opportunities. As the number of opportunities increases, hand hygiene performance decreases.

The red line is the 90th percentile of performance. The data shows that it’s increasingly difficult for clinicians to maintain high hand hygiene performance rates when they have a high number of opportunities. Those above the red line are stellar performers.

Here’s another way to look at the data. This Performance Bubble Plot™ shows one week’s worth of data for a small unit. Each bubble represents a badged clinician. The color of the bubble shows hand hygiene performance – darker green is higher and darker red is lower. The size of the bubble shows the number of hand hygiene opportunities – larger bubbles mean more opportunities. For the most part, the clinicians with the most opportunities (larger bubbles) have the lowest hand hygiene rates.

Six of these people represented 45% of all hand hygiene opportunities this week and present the greatest risk. But working with these individuals on workflow improvements can make a big difference, as we described in an earlier blog post. And here’s another blog post outlining real workflow improvements we’ve seen in the field.

Busyness certainly helps explain why healthcare workers don’t always clean their hands, along with Awareness. Next week, we’ll cover Craziness.

If you’d like to learn more about how our electronic hand hygiene reminder system provides this kind of data and decreases HAIs by over 66%, download our free white paper now. Or contact us so we can discuss your hospital’s specific needs.

This post is part of a series on The ABCs of Hand Hygiene.


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