Camilla McGuiness sees hand hygiene auditing as an opportunity
to educate healthcare workers about good hand hygiene behaviour.

Nurse Specialist, Infection Prevention and Control team
Auckland District Health Board
Hand hygiene gold auditor of the quarter, May 2012

With many years of gold auditing under her belt, Camilla McGuiness, a nurse specialist on the Infection Prevention and Control team at Auckland District Health Board, has fine-tuned her approach to auditing; allowing her to collect and submit compliance data by the submission date, while encouraging good hand hygiene practice as she goes.

For Camilla, auditing starts with a structured approach four to six weeks out from the submission deadline to ensure she can collect 350 hand hygiene moments from the wards that she audits.

“When auditing I try to take an inclusive, no surprises approach. This means informing the wards in advance, advising the charge nurse on my arrival, and explaining to healthcare workers what I am doing and what data I collect,” says Camilla.

“Coming across as friendly, approachable and knowledgeable is important, particularly when reinforcing the importance of hand hygiene to healthcare workers and clinicians.”

According to Camilla, this approach puts people at ease and means they quickly adjust to her presence, resulting in a more accurate reflection of actual hand hygiene compliance.

A key piece of advice Camilla has for auditing is to audit regularly for short periods of time.

“During the audit period I like to go to each ward, every day, for between 30 minutes to an hour,” says Camilla.

“This means I can easily incorporate auditing into my IPC business as usual work, which reduces the impact of auditing on my work schedule.”

Camilla also audits at times when she knows the ward will be at its busiest. This means she can collect a high number of moments in a relatively short period of time. She also visits different patient rooms to ensure she audits a good cross section of healthcare workers.

But for Camilla, auditing is not just about collecting performance data. Rather it presents another opportunity to educate healthcare workers about good hand hygiene behaviour, while promoting its importance to patient safety.

“Feedback is a really important part of the auditing process and it is important to feed back not only observations of poor hand hygiene behaviour, but also to feed back positive behaviour,” says Camilla.

“The way I approach poor hand hygiene behaviour depends on the risk. I may have to politely interrupt the healthcare worker, explain why and ask them to perform hand hygiene, or I will wait until they have finished and I will discuss it with them afterwards. I also follow up with the charge nurse,” says Camilla.

Feedback continues after auditing is complete and performance results are back. Camilla works with her usual IPC portfolio to highlight the key areas where improvement is needed.

“Remaining positive and encouraging is vital. It can make a real difference to whether a healthcare worker takes on board your comments,” she adds.