Date of Award
Summer 2025
Project Type
Thesis
College or School
CHHS
Department
Nursing
Program or Major
Direct Entry Master's in Nursing
Degree Name
Master of Science
First Advisor
Elizabeth Evans
Abstract
BACKGROUND:
Hospital-acquired infections (HAIs) are a major problem in healthcare, increasing patient morbidity, mortality, and costs. While staff hand hygiene is a well-established infection control measure, less attention is paid to patient hand hygiene (PHH) despite CDC recommendations.
LOCAL PROBLEM:
An intensive care unit (ICU) in northeastern Massachusetts had no formal policy for patient hand hygiene, and hospital leadership expressed support for enhancing infection control practices.
METHODS:
Using the Plan-Do-Study-Act model, a quality improvement project was implemented to encourage PHH before meals. Baseline PHH rates were collected through observation. The intervention involved registered nurses (RNs) directing patients to use hand sanitizer before eating. Pre- and post-intervention surveys gathered RN opinions about feasibility, supply availability, patient receptivity, and safety.
INTERVENTION:
Eligible patients received personal containers of alcohol-based hand sanitizer on meal trays and were verbally prompted by RNs to conduct hand hygiene before meals.
RESULTS:
PHH increased from 0% at baseline to 73.53% post-intervention. Survey results showed improved RN perceptions of feasibility and supply availability. While RN beliefs about the role of PHH in patient safety remained high, perceived patient receptivity improved only slightly.
CONCLUSION:
Directing PHH was a viable, cost-effective method that significantly improved hand hygiene compliance. The results suggest that PHH can be added to RN workflows to promote infection control and patient safety.
Recommended Citation
Davini, Nicholas, "Directing Patient Hand Hygiene Before Meals in the ICU: a Quality Improvement Project to Enhance Patient Safety" (2025). Master's Theses and Capstones. 1943.
https://scholars.unh.edu/thesis/1943