The BBCI ICU team consisting of 5 doctors, 1 technician and 2 sisters, and mentored by Dr Sarbani Laskar, was one of the teams from BBCI selected for National Cancer Grid EQUIP India Project 2023 under collaboration with Stanford Medicine. Beginning from August 2023, the team identified the problem of noncompliance in adhering to hand hygiene practices among health care professionals. Worldwide, hand hygiene compliance in ICUs is around 59.6%. By using the WHO hand hygiene observation form, a baseline of 40% compliance was obtained and target was kept at 70% by the end of the project. Root causes were identified by pareto analysis out of which three key drivers – multitasking (22.5%), careless behavior (43.75%) and lack of knowledge (73.1%) were the most significant. The following interventions were initiated to solve these problems:1) Comprehensive classes and demonstration of hand hygiene 2) Live demonstration of handwash 3) Daily flashing of hand hygiene in EMR 4) Posters depicting hand hygiene in critical areas 5) Personalized monitoring and incentivizing good behavior 6) Performance feedback forms.
Following these a target of 65% was achieved by the end of the project. The institutional impact would be reduced Ventilator Associated Pneumonia/bloodstream and urinary tract infections in ICU leading to reduced morbidity and mortality, shorter duration and decreased costs of ICU stay creating a safe and healthy environment in the ICU.
In future, our goals will be mandatory certificate course on hand hygiene for all employees, monthly rounds by HICC in whole hospital and interdepartmental competitions.
We thank Director Sir Dr B B Borthakur for his full support, Head of Anaesthesiology dept Dr Anupam Das for his guidance, Medical superintendent and ICU in charge Dr Minoti Baruah and the palliative team led by Dr K Bhagabati.
