National Data Period Three, 2013

Audit Period 3 - 2013 (October)
(NHHI Audit Three 2013)

Data have been collected nationally from a total of 752 hospitals from both the public and private sectors. The average compliance rate was 79% .

 Overall Compliance Rate

  Correct
Moments
Total
Moments
Compliance
Rate
Lower
95% CI
Upper
95% CI

Overall
Rate


384,643

487,175

79%

78.8%

79.1%

Compliance Rate by Moment

Moment Correct
Moments
Total
Moments
Compliance
Rate
Lower 95% CI Upper 95% CI
1 - Before Touching A Patient 104,285 139,305 74.9% 74.6% 75.1%
2 - Before Procedure 35,839 44,471 80.6% 80.2% 81.0%
3 - After a Procedure or Body Fluid Exposure Risk 47,791 55,116 86.7% 86.4% 87.0%
4 - After Touching a Patient 119,621 141,757 84.4% 84.2% 84.6%
5 - After Touching A Patient's Surroundings 77,107 106,526 72.4% 72.1% 72.7%
Click to Enlarge
Figure 1. National Hand Hygiene Compliance Rate By Moment
 

Compliance Rate by Health Care Worker

HCW Type Correct
Moments
Total
Moments
Compliance
Rate
Lower
95% CI
Lower
95% CI
Nurse/Midwife 268,599 323,832 82.9% 82.8% 83.1%
Medical Practitioner 43,066 65,452 65.8% 65.4% 66.2%
Personal Care Staff 14,751 20,440 72.2% 71.5% 72.8%
Allied Health Care Worker 17,930 23,021 77.9% 77.3% 78.4%
Administrative and Clerical Staff 1,630 2,207 73.9% 72% 75.6%
Invasive Technician 6,102 8,090 75.4% 74.5% 76.4%
Domestic 8,128 12,223 66.5% 65.7% 67.3%
Student Doctor 1,893 2,693 70.3% 68.5% 72%
Student Nurse/Midwife 17,892 22,656 79% 78.4% 79.5%
Student Allied Health 986 1,316 74.9% 72.5% 77.2%
Student Personal Care 103 143 72% 64.2% 78.7%
Other - Not Categorised Elsewhere 3,563 5,102 69.8% 68.6% 71.1%

Figure 2. National Hand Hygiene Compliance Rates by Healthcare Profession


Figure 1 depicts the compliance rates for each of the 5 Moments. The highest rates of compliance were after completion of a procedure (86.7%) and after touching a patient (84.4%). 
Figure 2 depicts the compliance rate by healthcare worker professional group. The highest compliance rates were nurses/midwives (82.9% for nurses/midwives and 79% for student nurses/midwives). 
 

 Medical Staff hand hygiene compliance rate by Moment

Moment Correct Moments Total Moments Compliance Rate Lower 95% CI Upper 95% CI
1- Before Touching A Patient 11,277 18,578 60.7% 60% 61.4%
2 - Before Procedure 3,815 5,362 71.1% 69.9% 72.3%
3 - After a Procedure or Body Fluid Exposure Risk 4,308 5,723 75.3% 74.1% 76.4%
4 - After Touching a Patient 15,201 20,499 74.2% 73.6% 74.7%
5 - After Touching A Patient's Surroundings 8,465 15,290 55.4% 54.6% 56.1%

Nursing/Midwifery Staff hand hygiene compliance rate by Moment

Moment Correct Moments Total Moments Compliance Rate Lower 95%
CI
Upper 95%
CI
1 - Before Touching A Patient 74,601 94,718 78.8% 78.5% 79%
2 - Before Procedure 27,356 33,027 82.8% 82.4% 83.2%
3 - After a Procedure or Body Fluid Exposure Risk 36,828 41,468 88.8% 88.5% 89.1%
4 - After Touching a Patient 83,003 94,978 87.4% 87.2% 87.6%
5 - After Touching A Patient's Surroundings 46,811 59,641 78.5% 78.2% 78.8%

Compliance Rates By Ward Type
Ward Type* Correct Moments Total Moments Compliance Rate Lower 95%
CI
Upper 95%
CI
Ambulatory Care 14,197 17,836 79.6% 79% 80.2%
Critical Care Unit 43,509 56,164 77.5% 77.1% 77.8%
Dental 639 805 79.4% 76.4% 82.0%
Emergency Department 17,543 24,630 71.2% 70.7% 71.8%
Maternity 11,743 14,585 80.5% 79.9% 81.1%
Medical 51,669 66,412 77.8% 77.5% 78.1%
Mental Health 3,208 4,130 77.7% 76.4% 78.9%
Mixed 31,575 39,382 80.2% 79.8% 80.6%
Neonatal Intensive Care Unit 7,277 8,534 85.3% 84.5% 86%
Oncology/Haematology 20,995 26,621 78.9% 78.4% 79.4%
Other 56,043 68,972 81.3% 81% 81.5%
Paediatrics 8,847 10,675 82.9% 82.1% 83.6%
Renal 17,500 21,057 83.1% 82.6% 83.6%
Sub Acute 14,391 17,193 83.7% 83.1% 84.2%
Surgical 84,296 108,809 77.5% 77.2% 77.7%
Transplantation Unit 1,211 1,370 88.4% 86.6% 90%

*See Appendix 1 for full explanation

Compliance Rates by Peer Group
Public hospitals only
Public Peer Group** Correct
Moments
Total
Moments
Compliance
Rate
Lower
95%
CI
Upper
95%
CI
Principal (n= 82)
189,539 243,959 77.7% 77.5% 77.9%
Large (n=39)
42,070 51,287 82% 81.7% 82.4%
Medium (n=77)
18,698 23,039 81.2% 80.7% 81.7%
Small (n=284)
27,634 32,802 84.2% 83.9% 84.6%
**See Appendix 2 for full explanation. These categories only apply to public hospitals. No Private Hospital data is included.
Principal = A1, A2
Large = B1, B2
Medium = C1, C2
Small = D1, D2, D3, E2, E3,E4, E9, F, G
Private hospitals only
Private Peer Group Correct
Moments
Total
Moments
Compliance
Rate
Lower
95%CI
Upper
95% CI
PPG 1 (n= 7) 18,502 24,446 75.7% 75.1% 76.2%
PPG 2 (n= 5) 10,892 13,806 78.9% 78.2% 79.6%
PPG 3 (n= 12) 19,953 26,230 76.1% 75.5% 76.6%
PPG 4 (n= 18) 13,866 17,626 78.7% 78.1% 79.3%
PPG 5 (n= 28) 15,224 18,578 81.9% 81.4% 82.5%
PPG 6 (n= 60) 11,029 13,780 80% 79.4% 80.7%
PPG 7 (n= 38) 3,233 4,278 75.6% 74.3% 76.8%

PPG 1 = >400 acute inpatient beds
PPG 2 = 301-400 acute inpatient beds
PPG 3 = 201-300 acute inpatient beds
PPG 4 = 151-200 acute inpatient beds
PPG 5 = 101-150 acute inpatient beds
PPG 6 = 51-100 acute inpatient beds

PPG 7 = <51 acute inpatient beds

Private day hospitals only

Day Hospital Peer Group Correct Moments Total Moments Compliance Rate Lower 95% CI Upper 95% CI
Large (n= 18) 4,623 5,797 79.7% 78.7% 80.8%
Medium (n= 22) 3,447 4,207 81.9% 80.7% 83.1%
Small (n= 30) 2,516 3,226 78% 76.5% 79.4%

Large = Stand alone facility performing >5,000 procedures per annum

Medium = Stand alone facility performing 2,000 -5,000 procedures per annum
Small = Stand alone facility performing <2,000 procedures per annum

Standalone and Satellite Dialysis Centres only

Dialysis Centres Peer Group Correct Moments Total Moments Compliance Rate Lower 95% CI Upper 95% CI
Large (n= 2) 627 757 82.8% 80% 85.3%
Small (n= 8) 744 949 78.4% 75.7% 80.9%

Large = Stand alone facility performing >5,000 procedures per annum

Small = Stand alone facility performing <5,000 procedures per annum

Appendix 1

Ward Type Categories

Ward Type
Further Definitions
Ambulatory Care

Out-patient clinic/treatment

Critical Care Unit

Including Coronary Care, Adult and Paediatric Intensive Care Units, High Dependency Unit

Emergency Department
 
Maternity

Delivery suite, maternity ward

Medical

Including dermatology, neurology, respiratory etc

Mental Health
 
Mixed
 
Neonatal Intensive Care Unit
 
Oncology/Haematology Unit

Including Day Oncology

Other

If not defined within the other categories

Paediatrics

Children’s Wards of Non-paediatric hospitals

Renal
Including dialysis
Sub Acute

Including rehab, geriatric evaluation and management

Surgical

Including neurosurgery, urology, ENT, ophthalmology, theatre, recovery etc

Transplantation Unit
 

Appendix 2

Public Peer Group Categories

Principal referral and specialist women's and children's
A1
Major city hospitals with >20,000 acute casemix adjusted separations and Regional hospitals with >16,000 acute casemix-adjusted separations per annum
A2
Specialised acute women’s and children’s hospitals with >10,000 acute casemix-adjusted separations per annum
 
Large hospitals
B1
Major city acute hospitals treating more than 10,000 acute casemix-adjusted separations per annum
B2
Regional acute hospitals treating >8,000 acute casemix adjusted separations per annum, and remote hospitals with >5,000 casemix-adjusted separations
 
Medium hospitals
C1
Medium acute hospitals in Regional and Major city areas treating between 5,000 and 10,000acute casemix-adjusted separations per annum
C2
Medium acute hospitals in Regional and Major city areas treating between 2,000 and 5,000 acute casemix adjusted separations per annum, and acute hospitals treating <2,000 casemix-adjusted separations per annum but with >2,000 separations per annum
Small acute hospitals
D1
Small Regional acute hospitals (mainly small country town hospitals), acute hospitals treating <2,000 separations per annum, and with less than 40% nonacute and outlier patient days of total patient days
Small acute hospitals
D3
Small remote hospitals (<5,000 acute casemix-adjusted separations but not 'Multipurpose services' and not 'Small non-acute'. Most are <2,000 separations
Small sub-acute and non-acute hospitals
D2
E2
G
Small non-acute hospitals, treating <2,000 separations per annum, and with more than 40% non-acute and outlier patient days of total patient days (D2) plus Multipurpose service (E2) – Small sub-acute and non-acute hospitals (G)
Australian Institute of Health and Welfare 2011. Australian hospital statistics 2009–10.
Health services series no. 40. Cat. no. HSE 107. Canberra: AIHW.