Table 14 'Hand-Hygiene - Measuring the Alcohol Consumption'

PSI 13: Hand Hygiene – Measuring the Alcohol Consumption
Origin: PSI by SimPatIE
Dimension Description
Description of Specific
Aspects of Patient Safety
Improved adherence to hand hygiene (i.e. hand washing or use of
alcohol-based hand rubs) has been shown to terminate outbreaks in
health care facilities, to reduce transmission of antimicrobial resistant
organisms (e.g. methicillin resistant staphylococcus aureus) and reduce
overall infection rates (40;41) also it is the cheapest way of preventing
nosocomial infections. Hand disinfection has been shown to be the
most effective method of hand hygiene (42).
The patient harm of bad hand hygiene makes surveillance of the
alcohol consumption a suitable patient safety measure.
Level of Determination of
Patient Safety
Safety is assessed at the aggregated patient level.
Aim of the PSI The PSI aims at monitoring the alcohol consumption used for hand
hygiene.
Source(s) This PSI is part of the Accréditation des médecins Programme by
Haute Autorité de Santé in France.
Extent of Clinically
Testing
This PSI is in use in numerous hospitals in Scandinavia, England,
France and other parts of Europe. Never the less no specific scientific
evidence describing clinical testing and validation of the PSI was
identified.
The Antimicrobial Resistance Prevention and Control study assessed
the organisation, components and human resources of infections
control programmes in European hospitals. A questionnaire survey of
policies and procedures implemented in 2001 for the surveillance and
control of nosocomial infection and antibiotic resistance was
completed by 169 acute-care hospitals from 32 European countries,
categorised by five geographical regions. A formal (Infection control)
IC programme existed in 72% of hospitals, and a multidisciplinary IC
committee was operational in 90%. Written guidelines promoted hand
hygiene for healthcare workers in 89% of hospitals, education in 85%,
and audit in 46%. Guidelines recommended use of alcohol-based
solutions (70%) and/or medicated/antiseptic soap (43%) for
decontamination of non-soiled hands. Use of alcohol-based solutions
varied according to region, from 41% in southern Europe to 100% in
northern Europe, compared with use of medicated soap from 77% in
southern Europe to 11% in northern Europe (p < 0.01). These findings
showed that IC programmes in European hospitals suffer from major
deficiencies in human resources and policies. (43).
Evidence of Clinically use
of Standards
This PSI has been used in Aarhus University Hospital, Denmark
together with another five PSIs related to hand hygiene. The standard
SImPatIE WP4 – Catalogue of Patients Safety Indicators
37
used for this PSI within the first year of monitoring was and increase in
the use for hand disinfection at 50%.
PSI category Theme Related PSI: “Infection Control”.
Data definitions Litre of alcohol consumption used for hand hygiene pr. patient in a bed
unit.
Numerator Description Alcohol consumption (Litre) relating to hand hygiene.
Denominator Description The number of patient per bed unit.
Data Source Registration of bought/delivered alcohol for hand hygiene.
Identifying the
institutional context
This PSI is relevant to quality improvement, accreditation and cost
containment, as prolonged hospital stays due to infections have
considerable economic impact.
Care Setting The PSI generally applies for high quality hygiene related to patient
contact.
Professionals Responsible
for Health Care
All health care providers dealing with patients in bed units.
Lowest Level of Health
Care Delivery Addressed
Individual clinical units or departments.
Allowance for Patient
Factors
No patient factors involved.
Stratification by
Vulnerable Populations
No stratification.
Standard of Comparison The time frame is monthly monitoring.
Scoring No specified scoring advice.