How a call for behavior change led to innovative solutions to better hand hygiene in a hospital in Denmark

After observations revealed that hand hygiene compliance during critical moments of care was lacking in Aarhus University Hospital’s oncology department, a team made up of behavior change professionals, facility leaders, engineers, and a nursing specialist created a strategy designed to improve hand hygiene amongst hospital staff. Initially, the strategy tested within the oncology department relied primarily on the use of Sani nudge – a technology system that can determine when a staff member has encountered a critical moment for hand hygiene and whether or not they used alcohol-based handrub to clean their hands by using sensors placed on alcohol dispensers and staff name badges. Prior to activating the system, handwashing signs and e-mails were sent to staff to remind them to clean their hands and facility leaders were positioned as champions for the new technology. While the system helped to track compliance and provided staff members with feedback on their hand washing behaviors, Sani nudge by itself was not enough to create lasting behavior change. These findings led the planning team to add other strategy components to the intervention, including weekly meetings with staff to discuss situations where hand hygiene could be improved, encouraging staff members to play an active role in setting goals, and inviting patients to play a role in reinforcing hand hygiene compliance among staff. Prior to the intervention, hand hygiene compliance around the staff toilet was less than 40%. This percentage increased to 90% post-intervention. The development team also noted drastic improvements in hand washing rates after patient contact as a result of the intervention.

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