• Stacy Haverstick, Cara Goodrich, Regi Freeman, Shandra James, Rajkiran Kullar, and Melissa Ahrens.
• Stacy Haverstick is a staff nurse on a cardiothoracic step-down unit at University of Michigan Health System, Ann Arbor, Michigan. haversts@umich.edu.
• Crit Care Nurse. 2017 Jun 1; 37 (3): e1-e8.

BackgroundHand hygiene is important to prevent hospital-acquired infections. Patients' hand hygiene is just as important as hospital workers' hand hygiene. Hospital-acquired infection rates remain a concern across health centers.ObjectivesTo improve patients' hand hygiene through the promotion and use of hand washing with soap and water, hand sanitizer, or both and improve patients' education to reduce hospital-acquired infections.MethodsIn August 2013, patients in a cardiothoracic postsurgical step-down unit were provided with individual bottles of hand sanitizer. Nurses and nursing technicians provided hand hygiene education to each patient. Patients completed a 6-question survey before the intervention, at hospital discharge and 1, 2, and 3 months after the intervention. Hospital-acquired infection data were tracked monthly by infection prevention staff.ResultsSignificant correlations were found between hand hygiene and rates of infection with vancomycin-resistant enterococci (P = .003) and methicillin-resistant Staphylococcus aureus (P = .01) after the intervention. After the implementation of hand hygiene interventions, rates of both infections declined significantly and patients reported more staff offering opportunities for and encouraging hand hygiene.ConclusionThis quality improvement project demonstrates that increased hand hygiene compliance by patients can influence infection rates in an adult cardiothoracic step-down unit. The decreased infection rates and increased compliance with hand hygiene among the patients may be attributed to the implementation of patient education and the increased accessibility and use of hand sanitizer.©2017 American Association of Critical-Care Nurses.

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