COMPLIANCE WITH HAND HYGIENE AMONG HEALTH CARE PROVIDERS: EFFECTS OF A SIX SIGMA IMPROVEMENT PROJECT

ABSTRACT Background: Good hand hygiene (HH) is of vast importance in mitigating the spread of hospital-acquired infections in hospitals, which are associated with higher morbidity and mortality rates and a greater cost of treatment. Good HH alone can significantly reduce the transmission of infection; however, adherence to recommended HH practices remains unacceptably low in most hospitals. Materials and Methods: The present study comprised one group in a pretest–posttest preexperimental design. All staff at the Prince Sultan Cardiac Centre were included and 520 observations were randomly obtained from these individuals before and after interactions with patients, with a similar number of observations collected after the implementation of the HH Six Sigma improvement program. Results: Half of the total observations were collected regarding nurses; the majority of the involved staff were 30 years to 39 years of age, and more than half of them were female. HH was performed in 65.4% of the occasions prior to contacting patients and in 82.3% of the occasions after contacting patients. After adding reminding posters, implementing educational programs, and affixing alcohol dispensers on the doors of patient rooms, HH compliance improved significantly and was performed by 90% of staff before contacting patients and by 93.5% of them after contacting patients. Females as compared with males and nurses as compared with technicians demonstrated significantly more HH compliance before contacting their patients. Conclusion: HH compliance improved significantly after implementing the quality improvement program. Our study results can be utilized as a backbone for any HH improvement program in hospitals. The completion of randomized longitudinal studies is recommended to ensure the sustainability of the improvement program effect on HH. Keywords: Hand hygiene, Compliance, Hospital-acquired infections, Six Sigma.