Embedding the hand-hygiene champion role to improve compliance in intensive care

Background: Studies have shown that hand-hygiene compliance rates remain low, especially in high-risk patient areas such as the intensive care unit (ICU). Strategies that use active surveillance, peer-to-peer coaching and collective action can potentially improve hand-hygiene compliance rates. Aim: To implement the hand-hygiene champion (HHC) role to increase hand-hygiene compliance rates in the ICU. Methods: The hand-hygiene champion role was implemented as a quality improvement project in the critical care directorate of two tertiary hospital sites in the UK. The project followed the Plan-Do-Study-Act cycle. The project was carried out from February 2025 to February 2026. Findings: Hand-hygiene compliance rates were significantly higher in the intervention group with HHCs, compared with the control group. In addition, hand-hygiene compliance rates significantly increased over time, post implementation of HHCs. Conclusion: Introducing HHCs can potentially improve hand-hygiene compliance in ICUs.