Nurse executives—and the nurses they lead—are indispensable champions of patient safety via total hand hygiene compliance programs. This includes being aware of never events, defined by The Centers for Medicare and Medicaid Services (CMS) as "serious, preventable, and costly medical errors." With new financial penalties from the CMS being imposed as part of the Hospital-Acquired Conditions Reduction Program, nurses must be knowledgeable and more vigilant than ever in leading the fight to combat never events, which, for the most part, are preventable. In addition to the serious toll they take on patient health and treatment costs, hospitals with rates above the national average of one percent now face new financial penalties.
The American Organization of Nurse Executives (AONE) identifies multiple strategies nurse executives can implement to safeguard patient safety and ensure full hand hygiene compliance within healthcare organizations and throughout a service area. As the AONE annual meeting is set to take place later this month under the theme of Empowering Leaders Igniting Change, let’s take a look at the role nurse executives can play.
Lead cultural change: Nurse executives can facilitate hand hygiene compliance through reward and recognition programs and diffusion of change and innovation throughout the healthcare enterprise. Especially vital is securing hand hygiene compliance buy-in from C-Suite and board members. Such was the case at Kankakee, Illinois-based Riverside Medical Center, which doubled its rate of hand hygiene compliance by forging a culture of collaboration and accountability supported by senior management.
Share leadership. Nurse executives must turn hand hygiene compliance into an enterprise-wide initiative and a standard operating procedure—in other words, “the way we do business around here.” Nurse executives can help re-shape the attitudes, beliefs, values and clinical and business agendas of executives, managers and staff via pay-for performance programs, non-monetary incentives and candid discussions of consequences. For example, nurse executives might remind staff that Medicare’s Hospital-Acquired Condition Reduction Program means that more than 700 hospitals have already seen their total Medicare payments reduced by one percent in fiscal year 2015.
Build alliances and partnerships. Hand-hygiene compliance begins in the home, at school, and at work and play. Nurse executives can spearhead and orchestrate practical, common-sense hand hygiene compliance behaviors by joining forces with employers, building and restaurant owners, educators, government officials and community leaders. Think about integrating hand hygiene compliance content into live and online hospital-sponsored classes, back-to-school programs and special promotional events, such as health fairs and screenings, taking care to target families, millennials, seniors and patients with chronic conditions like COPD, CHF, asthma and diabetes.
While nurse executives can easily tap into promotional resources from entities including the CDC and World Health Organization (WHO), they should also join forces with the marketing directors at their organizations. Doing so will ensure that hand hygiene compliance campaigns integrate the best in print, video, audio and online communications in the context of safety and quality performance. Equally important is working with technology vendors to install, monitor and train on the latest innovations to combat healthcare-associated infections (HAIs), such as an electronic hand hygiene monitoring system and UV light disinfection, as well as collaborating with hand hygiene product vendors to provide educational resources and in-service training on the skin care products the facility is using and proper hand hygiene.
Train and educate. Nurse executives must offer hand hygiene compliance education and training to reinforce hand hygiene competencies in the broader context of patient safety. Just as important, they must spearhead programs that help nurses and other clinicians secure accurate, timely hand hygiene compliance data. Only when nurse executives understand the true hand hygiene compliance rates of individual units, can departments and divisions develop programs that enhance hand hygiene performance.
Nurse executives have a vital role to play in ensuring patient and provider safety, a critical component of which is improved via hand hygiene compliance. Nurses can easily establish their role as patient safety champions by promoting best practices in culture building, shared leadership, partnership and training and education. The result is a safer healthcare environment and a decline in deadly HAIs.