Background Healthcare-associated infections remain a major concern in critical care environments. Hand hygiene (HH) compliance is a key preventive measure, yet maintaining consistent adherence remains challenging. A quality improvement (QI) initiative was undertaken to enhance HH practices among healthcare providers in a tertiary hospital in South India. Methods From August to December 2023, a QI project was implemented in Coronary Care Units (CCU) at KLE’s Dr. Prabhakar Kore Hospital. Using the Point of Care Quality Improvement (PoCQI) methodology, a multidisciplinary team applied WHO’s multimodal HH strategy through iterative Plan-Do-Study-Act (PDSA) cycles. Interventions included: (1) installation of centralised scrub stations with sterile footwear, (2) bedside multilingual posters, (3) structured staff training with night-shift monitoring and (4) real-time observation with feedback supported by leadership engagement. Weekly HH compliance and infection outcomes were tracked. Results Five PDSA cycles were conducted. Mean HH compliance improved from a baseline of 63.8% to 80.5% by week 20, reflecting a 26.7% relative increase and remained above 78% through week 30, confirming sustained gains postintervention. No methicillin-resistant Staphylococcus aureus , Pseudomonas or Klebsiella infections were reported during the intervention period. Blood culture positivity after 48 hours of CCU stay remained at 0%. Mortality trends varied and showed no consistent pattern attributable to the intervention. Conclusions Integrating WHO’s multimodal strategy with PoCQI led to a significant, low-cost improvement in HH compliance in a high-risk setting. This team-led approach demonstrated the impact of QI strategies in implementing cost-effective infection prevention practices in critical care settings.
Datta et al. (Mon,) studied this question.