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Victor Morris, MD, and Jeannette Bronsord, RN, (right) discussed hand hygiene with Molly Brosnan, RN, during recent leadership rounding on the Renal/General Medicine Unit (EP 7-5).

When it comes to hand hygiene, a little reminder from a co-worker can go a long way. That's why the HRO safety behavior Mentor Each Other - 200% Accountability has taken center stage in Yale New Haven Hospital's hand hygiene improvement efforts. Victor Morris, MD, associate chief medical officer, saw evidence of the behavior in action during a recent visit to a nursing unit, when an Environmental Services staff member reminded a physician who had just left a patient's room to clean his hands. The physician was already on his way to a sink, but thanked the staff member for the reminder, anyway.

"This is the kind of culture we want to create — one in which physicians, staff members and patients are empowered to speak up about hand hygiene, and the person on the receiving end thanks them for the reminder," Dr. Morris said.

He and Jeannette Bronsord, RN, director of Nursing, Surgery Services, are the new sponsors of YNHH's Hand Hygiene Charter Team, which includes members from different disciplines. The team is working to help each inpatient unit and the hospital as a whole reach hand hygiene compliance targets — a threshold goal of 88 percent and a stretch goal of 95 percent.

"Practicing good hand hygiene is one of the simplest, yet most effective ways to prevent hospital-acquired infections," Bronsord said. "These infections can be serious — sometimes deadly — to our patients, and they can spread to physicians and staff."

In addition to the use of CHAMP safety behaviors, the hospital's ongoing hand hygiene improvement efforts include physician and staff education, emphasis on hand hygiene during leadership rounding and anonymous hand hygiene monitors on inpatient units who document how often physicians and staff members clean their hands. The data they collect are broken down by service line, unit and employee role and tracked monthly. The data help identify lowperforming areas and guide improvements.

One problem monitors and others have identified hospital-wide is hand hygiene and glove use. The Hand Hygiene Charter Team reminds staff that gloves must be worn for all patients on contact precautions and, per standard precautions, when in contact with non-intact skin or body fluids. Everyone is expected to perform hand hygiene before donning gloves and after removing gloves. Gloves should not be washed or worn for multiple patients. For information on proper glove use and hand hygiene, visit the YNHH Infection Control Manual-Standard Precautions, or the World Health Organization website,