Emotional motivators: Using visual triggers as an infection control intervention to increase hand hygiene compliance throughout the hospital

Document Type

Conference Proceeding

Publication Date


Publication Title

Am J Infect Control


BACKGROUND: Healthcare acquired infections cost hospitals approximately $9.8 billion every year and there have been over 20 published articles demonstrating the effectiveness of hand hygiene in reducing infections. Despite implementing a variety of societal recommended methodologies to increase rates, our hospital rates have remained static. Recently, a publication suggested an effective way to increase and sustain hand hygiene compliance was to leverage emotional motivators, such as disgust. Having never taken that approach, we aimed to determine if it would be a method for increased compliance. METHODS: To stir a feeling of disgust, we compiled a book of bacterial culture images with congruent Adenosine Triphosphate (ATP)meter readings of healthcare worker hands of objects on the unit. We then compiled hand hygiene compliance data to determine which four units had a low compliance rate (with sufficient stealth observations). Over 2 months we performed 10 intervention days on the selected units, where we would collect ATP readings of staff hands, then show them what a culture of a similar reading looked like. RESULTS: Before beginning the study, the hand hygiene compliance rates of the units were calculated using the number of compliant observations/total number of observation x 100%. The rates were as follows, I1: 47.4%, F6: 50%, C6W: 33.3% and B1: 50%. To evaluate the possible effectiveness of the method we recalculated compliance midway through, or after 5 intervention days. Those rates were 58.3%, 58.3%, 50% and 88.9% respectively. Once we had completed all 10 interventions we recalculated the compliance, I1 58.3%, F6: 68.4%, C6W: 80.9% and B1: 68.8%. CONCLUSIONS: In conclusion, all units experienced an increase of at least 11 percentage points. Using this uncommon methodology, other institutions could also positively impact their rates by influencing their staff to visually connect the images of microbial contamination with noncompliance of hand hygiene, effectively working towards reduced infection rates. (Table Presented).




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