Proper hand hygiene is the foundation of an effective infection prevention program, but in the daily hustle of the surgical schedule, the critical importance of its meticulous details are occasionally taken for granted. Here's some compliance-boosting advice.

— Compiled by David Bernard

• Someone might be watching. Forget the observers with clipboards. Enlist a rotating "spy team" of administrative and staff volunteers to watch hand hygiene practices, or lack of them, among a designated number of employees per day from their usual vantage points in pre-op, the OR, PACU or the corridors in between. After a few monthly reports and a few teachable moments, the known possibility of secret monitors will likely boost your confidence in compliance.



• Credit where credit is due. Enforcing hand hygiene rules among your staff is important, but so is praising their achievements. When the reports are good and compliance rates are rising, let them know. Some administrators hang congratulatory posters in the staff lounge and outside their offices to celebrate the improvement and thank staffers for their efforts.



• Double up on dispensers. Installing hand sanitizer dispensers inside your ORs as well as outside of them, at the scrub stations, will bring about a dual infection prevention benefit. First, it'll make sure that compliance is close at hand, no matter which side of the doors your surgical staffers are on. And second, it will limit exits from and entries into the rooms, since OR traffic is a potential source of SSIs.



• Always on hand. Making hand hygiene opportunities convenient will make hand hygiene compliance rise. Some facilities have seen improvement after issuing travel-size, clip-on bottles of hand sanitizer to each nurse and tech, to wear on their scrubs. Another way to ensure the disinfection of digits between patient contacts is to keep pump bottles of the gel in IV kit baskets, so your staff can sanitize without interrupting the process.