Clean Care is Safer Care

Case study

El Hospital de Especialidades Centro Médico "La Raza", Azcapotzalco, México

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Submitted by:

Ulises Angeles Garay
Hospital De Especialidades Centro Medico La Raza IMSS,

What type of health-care facility or organization are you?

This 580 bed hospital (with 25 medical and surgical specialties) admits 1400 patients on average each month and performs approximately 550 surgeries per month. The mortality rate is about 6.5%

What was the situation at your facility with respect to hand hygiene and HAI before you initiated the hand hygiene initiatives?

The hospital's Infections Committee identified an average of 120±20 infections per month through active surveillance.

What were the goals of your initiative?

To promote compliance to hand hygiene and to reinforce the technique of hand washing.

What actions have you planned or already put in place to improve hand hygiene at your facility?

Health-care professionals consisting of doctors, nurses, and the Infections Committee visited hospitalized patients to promote the need for correct hand washing procedure. The patients and their visiting family were requested to remind doctors, nurses, chemical health technicians and other workers to wash their hands or disinfect them during patient care.
The importance of hand hygiene was reinforced in discussions with health-care workers.

Did you encounter any particular problems while planning and implementing your strategy?

Hand hygiene and hand washing are not included in the University curriculum. Training and education on washing and disinfecting hands in hospitals is not part of university academic programs. Therefore when new doctors, new residents, and recently graduated nurses start work there is a problem.

What were the outcomes of your initiatives?

Initially 20% of staff complied with correct hand hygiene procedure, which later increased to 65%. The hospital has set a goal of 100% compliance in May.

What were your key learning points?

People participate when you talk directly to them. Documents or offices do not have the same impact as monitoring procedures.

What are your future directions?

It is planned to suggest and promote inclusion of hand hygiene in curricula of doctors, nurses and other health professionals. Time has to be given for teaching the importance and benefits of washing hands or disinfecting them when we serve patients.

Additional comments:

Hand washing is very easy to practice. It is the most cost-effective strategy to prevent infection. And due to its simplicity, it has been neglected and the consequences are severe. We know the benefit and should promote this practice and put it on top of any progress in medicine.