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6 HAND HYGIENE Compliance Falls Shortest on WHO's Fifth Moment of Hand Hygiene: 3 Study Findings By Shannon Barnet O f the World Health Organiza- tion's Five Moments for Hand Hygiene, compliance tends to be lowest on the final step, according to a study published in the American Journal of Infection Control. e Five Moments for Hand Hygiene defines five key times healthcare per- sonnel should wash their hands: before touching a patient, before performing a clean or antiseptic procedure, aer bodily fluid exposure risk, aer touching a patient and aer touching a patient's surroundings. e study on hand hygiene compli- ance was conducted in the U.K. using both observation and a focus-group in- formed questionnaire. All total, 484 par- ticipants were observed and 410 returned a completed post-observation survey. e study found: 1. Compliance with the fih moment for hand hygiene — aer touching a patient's surroundings — was lowest of the five moments. Roughly 93 percent of partici- pants performed hand hygiene following the fih moment and compliance varied between regions studied, but not by pro- fessional group. 2. More than 65 percent of the respon- dents said on the questionnaire that the fih moment was clearly defined, achiev- able, valuable, encouraged and widely known. However, 60 percent also argued that it is repetitive. 3. ere was a positive association be- tween the performance of hand hygiene following the fih moment and the perception that the final step was widely known. "Interventions to improve com- pliance with the fih moment should focus on promoting awareness of the fih moment and how it should be implemented in practice," concluded the study authors. "Mechanisms for raising awareness should include education and role modeling." n Memorial Hermann Reduces HAIs With Hand Hygiene Tool By Shannon Barnet I n 2010, Houston-based Memorial Hermann Health System implemented a Joint Commission tool to improve hand hygiene in 12 of its hospitals. A study published in the January issue of The Joint Commission Journal on Quality and Patient Safety shows the tool yielded promising results. The Joint Commission Center for Transforming Healthcare's web-based targeted solutions tool for improving hand hygiene allowed MHHS to measure compliance rates, identify reasons for noncompliance, implement tested interventions provided by the tool and sustain the improvements. Results of the study show MHHS' hand hygiene com- pliance rate increased from the baseline of 58.1 percent from October 2010 to May 2011, to 84.4 percent during the "improve phase" from June 2011 to November 2012. Compliance rates continued to grow during the "control phase," from December 2012 to December 2014, to 94.7 percent, and during the final 12 months of the study to 95.6 percent. Also, in association with the increase in hand hy- giene compliance, central line-associated blood stream infections decreased 49 percent and ventilator-associ- ated pneumonia rates decreased 45 percent during the course of the study. n Flashing Lights Improve Hand Hygiene Compliance, Study Finds By Shannon Barnet R esearch has shown flashing lights can help in- crease hand hygiene compliance in healthcare set- tings, but the longevity of the effect has not been examined — until now. A study published in the American Journal of Infection Control looked at how flashing lights affect hand-washing over the course of six weeks. The researchers mounted flashing lights onto hand sanitizer dispensers for a month and a half and used re- gression analysis to compare hand hygiene compliance rates at the beginning of the intervention to the end of the intervention. The study showed flashing lights improved hand hy- giene compliance from 11.8 percent to 20.7 percent. Not only that, the effect remained the same over the course of the six-week study period. The researchers also found fully charged lights were linked with greater compliance. "Flashing lights are a simple, inexpensive way of improving hand hygiene," the study concluded. "Brighter lights appear to have a greater effect; however, this must be balanced with annoyance in specific settings." n