Evaluation of a hand hygiene campaign in outpatient health care clinics

Full kudos to my colleague Kate KuKanich, an assistant professor in the veterinary college at Kansas State, for managing clinics, a kid, bringing me duck eggs when I’m in town, and shepherding this project through to completion.

It’s the third paper we’ve published together in two years, with another kate.jackone on the way. Who says I can’t collaborate.

Evaluation of a hand hygiene campaign in outpatient health care clinics

Am J Nurs. 2013 Feb

Kukanich KS, Kaur R, Freeman LC,  Powell, D.A.


An intervention improved the frequency of hand hygiene attempts.


To improve hand hygiene in two outpatient health care clinics through the introduction of a gel sanitizer and an informational poster.


In this interventional study, health care workers at two outpatient clinics were observed for frequency of hand hygiene (attempts versus opportunities). Gel sanitizer and informational posters were introduced together as an intervention. Direct observation of the frequency of hand hygiene was performed during baseline, intervention, and follow-up. A post-study survey of health care workers was also distributed and collected.


In both clinics, the frequency of hand hygiene was poor at baseline (11% and 21%) but improved significantly after intervention (36% and 54%) and was maintained through the follow-up period (32% and 51%). Throughout the study, post-contact hand hygiene was observed significantly more often than pre-contact hand hygiene. In both clinics, health care workers reported a preference for soap and water; yet observations showed that when the intervention made gel sanitizer available, sanitizer use predominated. Fifty percent of the surveyed health care workers considered the introduction of gel sanitizer to be an effective motivating tool for improving hand hygiene.


Hand hygiene performance by health care workers in outpatient clinics may be improved through promoting the use of gel sanitizer and using informational posters. Compared with surveys, direct observation by trained observers may provide more accurate information about worker preferences for hand hygiene tools.