The nurse is a member of the hospital’s infection control team. The hospital initiated a robust re-education effort about hand hygiene and ensured that all staff had ready access to alcohol-based hand rub, as well as soap and water for visibly soiled hands. The increased compliance with recommended hand hygiene practices was evident during the initial months of the initiative. As time passed, the infection control committee members observed decreased compliance with hand hygiene recommendations.

1.

What CUES (Assessment) can the nurse and the infection control team assess, using the DSF framework, about the lack of sustained compliance with hand hygiene recommendations?

2.

What HYPOTHESIS (Diagnosis) can the nurse and the infection control team consider about reasons compliance would decrease over time?

3.

What ACTION (Plan and Implement) will be most effective for the nurse and the infection control team to take to ensure increased compliance with hand hygiene and the provision of safe quality healthcare that protects patients and staff?

4.

How will the nurse and the infection control team evaluate the OUTCOME (Evaluation) of the team’s work for the purpose of arriving at sustained compliance to the hand hygiene recommendations?