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Wards should decide own handwashing protocols to boost compliance


Trusts should abandon rigid, organisation-wide handwashing protocols in favour of allowing individual wards and teams to decide the approach that works best for them, according to a leading nurse turned NHS manager.  

Professor Tricia Hart, chief executive of South Tees Hospitals Foundation Trust and a patron of the Infection Prevention Society, said strategies to ensure health professionals complied with hand hygiene guidance should not take a one-size-fits-all approach.

Speaking at the society’s annual conference last week, the former director of nursing said that while increasing awareness of the importance of hand hygiene was relatively easy, generating and sustaining behaviour change was difficult.

To achieve long-term behaviour change required taking a range of approaches to suit individual environments, she told delegates.

“Large organisations have micro-cultures that can be quite different, and what works for one might not for another,” she said. “Organisations need to have a range of education and awareness tools to engage staff, so that leaders in each area can adopt the ones that work for them.”

Professor Hart, who was the nursing advisor to the Mid Staffordshire Foundation Trust public inquiry, also said hand hygiene strategies should focus on outcomes rather than processes.

“The important thing is achieving behaviour change and preventing avoidable infections, not the process of doing this,” she added.

“In my organisation we have used direct training from the infection prevention team, focus groups, posters and forums, and allowed different teams to decide which approach suited them. The only thing we standardise is how we report on the outcomes.”

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Readers' comments (3)

  • I can't see a problem with this. I mean its not as if the NHS has had any issues recently with Trusts deciding not to follow or enforce guidelines that everyone else tries to follow and then had lots of unexpected deaths or anything like that.

    Oh wait a minute....

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  • michael stone

    The question of whether everyone should be following a single 'set of rules' for something, or developing a 'local approach', is complex.

    I'm sure Tricia understands that, and of course she is correct to say that (to paraphrase) 'the important bit, is that everyone is doing something that works well'.

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  • have you had the opportunity to consider the use of hand hygiene/sanitizers that are alcohol base, for addiction and mental health rehab centres and/or inpatient units? Is it an issue? Have you considered any other options, are there products without the alcohol?

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