The Johns Hopkins Children’s Center recognizes the simple power of clean hands to prevent the spread of infection. Aiming to achieve ever better compliance with existing hand hygiene requirements, administration and staff have instituted a new Pediatric Hand Hygiene Initiative. The goal of the initiative is to encourage communication and feedback among all employees involved in patient care in the Children’s Center. As part of this effort, all Children’s Center employees are responsible for observing and responding to instances of hand hygiene, whether compliant or non-compliant.

“With this new campaign, we ask every employee to recognize his or her own critical role in keeping our patients safe,” says pediatric infection control practitioner Beth Griffith, who, with fellow infection control practitioner Maggie Cantara, is helping to manage the campaign. “We are working toward achieving at least 90 percent compliance with existing rules that require everyone to wash their hands or use hand sanitizer every single time they enter or leave an occupied patient’s room.”

Building upon the hospital’s existing “secret shopper” program, in which trained participants watch traffic in and out of patient rooms and calculate rates of hand hygiene compliance, the Pediatric Hand Hygiene Program asks every employee to observe daily the hand hygiene practices of another, and relay to that individual either thanks for proper practices or polite notice that proper measures were not practiced.

Without naming observed individuals, each employee is asked to fill out daily a “hand hygiene observation card,” describing what he or she observed and whether feedback was given. Pink and green cards are available on every pediatric unit. All Children’s Center employees are asked to fill out pink cards; green cards are reserved for physicians.

“We want to change the culture here,” says Griffith. “Safe patient care is everyone’s responsibility. We want to make it OK for everyone to speak up, no matter your role in the hospital.”

Pediatric nursing leadership first observed a similar program on a site visit to another children’s hospital, where it was helping to change culture and foster discussion, says Cantara: “So we set about to introduce it here.”

In this program, Griffith adds, “we ask people to be gracious and accepting of observation. We are simply reinforcing the message that even in this complex and fast-paced environment, hand hygiene is paramount.”