Hand Hygiene New Zealand (HHNZ) has contracted with the Health Quality & Safety Commission since 2011 to improve hand hygiene in New Zealand hospitals.
This rapid evaluation (available to download below) aimed to assess the impact the programme has had to date, and whether it had affected clinical outcomes. The evaluation included:
- analysing documents created by HHNZ – including monitoring reports, reviews and resources
- a quantitative analysis of the audit results and infection measures by district health board
- a qualitative analysis involving key informant interviews with semi-structured questions and a thematic analysis
- a brief literature review and synthesis of approaches suggested from the interviews to take hand hygiene forward into the future.
Key points identified by the evaluation team
- There has been a clear improvement in hand hygiene measures with results averaging over 70 percent adherence with hand hygiene opportunities.
- The focus on quality improvement approaches related to continuous quality improvement and a focus on building culture (eg, frontline ownership, PDSA cycles, peer support and leadership) is more successful than a pure surveillance approach.
- The improvement that has been achieved is in the early adoption stages and needs on-going support to truly embed this change in a more sustainable manner as part of the fabric of the health care system.
- Support is needed to generalise effective hand hygiene practice throughout the sector.
- An on-going national approach is needed in the following areas:
- strategic oversight and leadership functions
- maintaining IT infrastructure for data collection
- maintaining links with Australian hand hygiene programme
- audit data management and reporting
- ensuring maintenance of gold auditor training capacity
- continued resource refreshment, refinement and development
- website maintenance, development and promotion
- continued proactive support for DHBs
- engagement with practitioner organisations and educational institutions
- assistance for hospitals to expand practice to all areas of clinical care
- annual national workshop/shared learnings
- publicity and social marketing about hand hygiene, including publications
The Commission is working with HHNZ to implement the recommended approach