Clean Hands in Rwanda

April Budd, GHLI Health Management & Leadership Mentor

In 2013, Muhima Hospital started on its journey to improve hand hygiene for its patients, staff and visitors. For years, the hospital struggled to provide proper hand sanitizing resources to employees and patients. At times, a department would have soap but a non-functioning sink, or the sink would be working and soap was absent. In cases where both were present, there was the issue of no paper towels to properly dry hands. This occurrence led to staff members who diligently wash their hands having to use their own, often soiled, clothing to dry hands, therefore re-contaminating recently cleaned hands. 

After hand hygiene was acknowledged as a deficiency at the Hospital, the Human Resources for Health Program (HRH) management and leadership team joined Muhima to work on pertinent quality improvement needs. The HRH managers from Centre Hospitalier Universitaire de Kigali (CHUK) suggested implementing hand sanitizer production locally. In January 2014, specifically trained staff produced the first batch of sanitizer at Muhima Hospital using a formula from the World Health Organization. Over the next six months, a Hand Hygiene Initiative team managed a gradual roll out to implement the hand sanitizer project across the hospital including sensitization sessions and demonstrations to teach physicians, nurses and staff on the most effective sanitizer use methods.  

Currently, hand sanitizer is available for patients, staff and visitors in all inpatient departments at Muhima Hospital and hopefully will be in outpatient areas this month. The team most recently celebrated acceptance to the Infection Control Africa Network conference to be held in Harare Zimbabwe this year at which they will present on lessons learned from the process. This project has largely been successful, not only due to a having a great team pushing it out to users, but mostly due to the staff buy-in. The staff are demanding the hand sanitizer through utilization and ordering and due to a good planning team, the hospital is prepared to meet the need.