Using the Hy5 app for Hand Hygiene (HH) observations

Why?

Everyone can get involved in our goal of 100% hand hygiene compliance
We need to dramatically increase how many observations we make to improve the validity of our results and meet new standards for accreditation
More locations can be reviewed for a more complete picture of the hospital
It will provide nearly real-time data to Infection Control to make more timely interventions

What?

An app that everyone can use to contribute to hand hygiene observations
4 simple taps, then submit – that’s all it takes
You can include optional comments to provide detail if needed

Where?

Make observations for ALL locations including inpatient units, procedural areas, emergency and perioperative care locations, and ambulatory care sites

Who?

Collect observations for everyone (all health care professionals, support staff, students, volunteers) EXCEPT patients and visitors
First responders to an emergency situation may be time-limited, and these situations should NOT be considered HH failures
The name of the person being observed is not collected

When?

Look for HH opportunities that may result in compliance or non-compliance, not just when HH is used (recording HH failure is equally important)
Use for any contact with the patient or their environment, even if very brief
If someone uses HH, but ultimately does not initiate contact, it’s encouraged to record an observation as "Before"

How?

(make no assumptions, just record what you see)

ACTION

Gloves do NOT count as hand hygiene (record as "None") except: housekeeping staff can wear the same gloves to collect soiled items from multiple rooms as long as they touch NOTHING else, including doors or furniture
Hand hygiene does not have to be done directly outside the patient’s room (e.g., dispenser in hallway, sink outside the next patient’s room) as long as it is still before or after contact
Watch out for 2-step HH, "Wash, then Disinfect" and "Disinfect, then Wash"
If someone preforms HH, then handles a "dirty" item before patient contact, this should be recorded as "None". Similarly if someone handles a "clean" item (e.g., their iPhone) after patient contact and before HH, this is also "None"

TIMING

Record whether the HH event was "Before" or "After" contact with the patient or their environment
When observing someone moving from a dirty to a clean task, record this as "After"
A single HH event may serve as "Before" in on observation, AND "After" in another observation

ISOLATION

Choose "Contact" if a Contact isolation sign is posted
Choose "ContactPLUS" if you see that sign posted, with or without a Contact sign
For any other type of room, choose "None/Other"

ROLE

Make your "best guess" of the role of person you observe

…then just tap "Submit"!

Examples:

"Hall Pass"

You see a physician walking down the hallway and she stops briefly to get some hand sanitizer from a dispenser on the wall. She continues down the hallway, and without touching any personal items or door handles, enters a patient room without isolation precautions.

You record this as:
Disinfect, Before, None/Other, MD

Explanation:
Hand hygiene may take place away from the patient room

"Before and After"

You see a nurse emerge from a ContactPLUS patient room, washes his hands in the sink and then uses hand sanitizer, and immediately enters the adjacent patient room.

You record 2 observations:
1. Wash then Disinfect, After, ContactPLUS, RN.
And also:
2. Wash then Disinfect, Before, None/Other, RN

Explanation:
A single hand hygiene action can serve two purposes

"Family visit"

You see several family members, some holding their phones, walk into a patient room with a ContactPLUS isolation sign, and no one stops to sanitize or wash their hands.

You record nothing.

Explanation:
Though encouraged to use good hand hygiene, family and visitors are not subject to the same requirements as health care workers.

"Ring, Ring"

You see a physician emerge from a patient room with a Contact isolation sign, and as he heads toward the sink, his phone rings and he takes a brief call, then proceeds to wash his hands and leave.

You record this as:
None, After, Contact, MD

Explanation:
After patient contact, hand hygiene must be performed BEFORE touching anything in the work environment (this includes personal items such as a phone, or shared items such as a computer workstation.)

"Nice picture"

You join a physician in the patient’s room and the physician only talks to the patient but does not make any contact. Just before you both leave, he notices a photo frame on the patient’s bedside table, and he picks it up to look at it and says, "beautiful family!". He leaves the room and walks over to a computer and starts typing.

You record this as :
None, After, None/Other, MD

Explanation:
Hand hygiene should be performed after contact with the patient OR their environment. In this case, the patient’s photo was part of their environment so hand hygiene should have been performed.