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How to get doctors to hand hygiene: nudge nudge
Vallgarda S: Nudge- A new and better way to improve health? Health
Policy
How to get doctors to hand hygiene: nudge nudge
A Kwok 0
M-L McLaws 0
0 School of Public Health and Community Medicine, UNSW Medicine , Sydney , Australia
Objectives
To engage medical staff towards improved hand hygiene
compliance.
Methods
An automated hand hygiene surveillance system was
installed in an Australian tertiary teaching hospital. The
clinicians were taught to access a dashboard for daily
compliance rates to be discussed at hand-over meetings
and to use a seven-step approach that included nudging
each other on the wards with “Doctor, take a moment”.
Feedback from clinicians about nudging and rates on
both wards from June 2014 to February 2015 were
compared.
Results
During the run-in period prior to introducing nudging
the baseline compliance rate was 18% on ward C and
37% on ward D. Preliminary results indicated one ward
has improved by 32 percentage points while compliance
on ward C remained stable at 15%. Clinicians on ward
D reported that they were comfortable working as a
team to nudge each other towards a goal of improved
daily compliance and it was fun. Conversely, ward C
clinicians reported a discomfort with nudging each
other and were observed to have a different ward
culture than ward D. We will discuss the difference in
the staff and leadership on the wards that may explain
the opposing attitudes towards nudging.
Conclusion
Nudging daily compliance rates by nurses and doctors
resulted in collegiality and developed a ‘team
consciousness’ about improvement in compliance. Changing hand
hygiene compliance must work with different
organization cultures on wards for effective change management.
Disclosure of interest
A. Kwok Conflict with: Deb Australia, Debgroup UK
provided the automated system to collect daily
compliance rates. The authors declared have no other conflict
of interests. , M.L. McLaws Conflict with: Deb Australia,
Debgroup UK provided the automated system to collect
daily compliance rates. The authors declared have no
other conflicts of interest. (...truncated)