4 most important improvements to your hand hygiene program


Posted by Kimberlee Aubrey RN

Is your hospital’s hand hygiene program just going through the motions?

…Or does it provide “on the spot" correction and education?

Hand Hygiene | Readiness Rounds
According to an article recently published by The Joint Commission, lack of “just in time” correction and education is one of the top contributing factors to healthcare workers (HCWs) not performing hand hygiene. (2) Though it has shown significant positive impact on HCWs, “on the spot” interventions are missing from many hospital hygiene programs. (4) So why is it that hospitals choose not to implement this method as part of their programs?

Some of these reasons include:

  • Lack of available staff
  • Perception of lack of resources
  • Staff reluctancy to scrutinize and correct peers or supervisors
  • A hospital culture that does not permit peer correction - seeing it as punitive rather than a collaborative effort to improve safety

If hand washing is the most immediate way to prevent the spread of hospital associated infection (3) and lack of “on the spot” coaching is one of the top reasons why healthcare workers do not wash hands (2), doesn’t it make sense to give “real time” coaching serious consideration?

[Infographic] Hand Hygiene: The Dirty Facts | Readiness Rounds

Looking through the eyes of the patient, it would seem unfathomable that a staff auditor would observe a healthcare worker not wash their hands and then continue to observe the healthcare worker potentially spread infection! If the only action in this scenario is to checkmark the “non-compliant” box, then we are not doing right by our patients.

What can hospitals do to improve their hand hygiene?


Leaders must pledge not only to allow resources to collect solid data but to also assign resources to improve performance.


Education must transpire at multpile intervals: upon hire, annually, and when job responsibilities change (1) and include collective responsibility and accountability as part of the curriculum.


All HCWs must be taught that it is permissible and expected that they remind each other.


Train observers to provide real-time education while they are doing their audits. This not only serves to educate the staff member but it actually impacts the patient’s safety at the point of care by preventing the spread of infection.

With hand hygiene statistics reporting as low as 40-50% adherence (1, 2) and studies showing that "on the spot" correction and education works to improve compliance (4), isn’t adding it to your hospital’s program worth serious consideration? 

Hand Hygiene | Readiness Rounds

Readiness Rounds hand hygiene solution allows you to perform hand hygiene checklists quickly and accurately. Download a sample here.


(1) Ellingson, K., Haas, J. P., Aiello, A. E., Kusek, L., Maragakis, L. L., Olmsted, R. N., & ... Yokoe, D. S. (2014). Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene. Infection Control & Hospital Epidemiology, 35(8), 937-960. doi:10.1086/677145

(2) Improving Hand Hygiene at Eight Hospitals in the United States by Targeting Specific Causes of Noncompliance. (2015). The Joint Commission Journal on Quality and Patient Safety, 41(1), 4-12. Retrieved August 7, 2015, from

(3) Mathai, E., Allegranzi, B., Seto, W., Chraïti, M., Sax, H., Larson, E., & Pittet, D. (2010). Educating healthcare workers to optimal hand hygiene practices: addressing the need. Infection, 38(5), 349-356. doi:10.1007/s15010-010-0047-7

(4) Lowry, F. (2015, July 2). On-the-Spot Intervention Improves Hand-Hygiene Practices. Retrieved August 9, 2015, from

Topics: Hand Hygiene, Patient Safety & Clinical Quality, Healthcare Associated Infections

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