Dissertation
Improving Hand Hygiene Compliance in the ICU
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
Background Healthcare-associated infections (HAIs) affect 1 in 31 patients and contribute to nearly 75,000 deaths annually. The rise of Candida auris, a multidrug-resistant pathogen with mortality rates up to 60%, has heightened the need for infection control (CDC, 2023). Although hand hygiene is the most effective method to prevent HAIs, compliance in ICUs remains suboptimal often below 50% due to workflow demands and limited access to hand sanitizer (WHO, 2009; Rybak et al., 2021). Similar barriers were identified at a large Midwestern academic hospital s medical ICU.PurposeTo improve hand hygiene compliance in a 26-bed medical ICU using a multimodal intervention guided by the Iowa Implementation for Sustainability Framework.MethodsThe intervention included staff education, standardized placement of hand sanitizer bottles on bedside supply carts, visual reminders, and real-time observational feedback. Data were collected through direct observations across six key hand hygiene opportunities, self-assessment surveys, and infection surveillance using the hospital s Tableau system. Statistical analyses included chi-square tests, Mann-Whitney U tests, and paired t-tests.FindingsCompliance increased from 63.6% to 76.4% post-intervention (p = .005, Cram r s V = 0.14). Self-assessment scores improved from 0.79 to 0.84 (on a 10 cm scale), significantly higher when sanitizer was accessible (p = .004). Though not significantly, knowledge scores rose (mean 27.8 to 31.2) (p = .261). CLABSI rates declined from 1.0 to 0.0 in the final three months; CAUTI remained at zero.DiscussionThis project demonstrated that structured, low-cost interventions can significantly improve hand hygiene compliance when embedded in workflow and supported by environmental modifications. The findings underscore the importance of accessible sanitizer placement, ongoing education, and leadership support to sustain long-term gains in infection prevention and patient safety.
Details
- Title: Subtitle
- Improving Hand Hygiene Compliance in the ICU
- Creators
- Jessica Fung - University of Iowa
- Contributors
- Julie Stanik-Hutt (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Adult/Gerontology Nurse Practitioner (Acute Care)
- Date degree season
- Spring 2025
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright 2025 Jessica Fung
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841036302771
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