Formative Interventions to Improve the Hand Hygiene Procedure in Your Emergency Department

OBJECTIVES: Poor hand hygiene compliance (HHC) in the emergency department (ED) is a source of nosocomial infections with serious consequences for patients. Despite the efforts of health organizations to improve this process, HHC is still insufficient. This qualitative research explores some reasons for this problem. METHODS: A virtual change laboratory (CL) is integrated into an ED of a university health center and brings together emergency personnel. The experimental ED is randomly compared to a control facility. The impact of the pandemic on the hand hygiene procedure is analyzed in light of the CL intervention. RESULTS: Healthcare professionals are very familiar with the hand hygiene procedure in the ED and have a high level of agency (TaG) that allow them to be receptive to changes supporting the modeling of a hygiene process that is healthy. However, HHC remains low even during the pandemic. The main reasons for this problem are the need for handwashing that is not recognized by the staff, as well as organizational barriers related to equipment. To remedy this, the CL proposes a technological tool that encourages this procedure by creating a reminder when the professional enters or exits the patient’s space bubble. The patient can act as a tool by stimulating the action of handwashing and contributing to the process evaluation. CONCLUSIONS: A virtual CL is used as a techno-pedagogical tool to systematically analyze a major organizational problem and facilitate learning in an ED. The main factors contributing to low HHC are the failure to recognize the need for handwashing and challenges arising from the physical organization, such as the quality, quantity, and location of materials. Involving the patient as a sentinel could assess and stimulate the hand hygiene procedure among healthcare professionals.