Date Available


Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Sheila Melander

Clinical Mentor

Dr. Kristin Pickerell

Committee Member

Dr. Melanie Hardin-Pierce

Committee Member

Dr. Lewis Perkins


PURPOSE: The purpose of this study was to develop and implement a patient hand hygiene protocol (PHHP) to improve patient outcomes, specifically to decrease the rates of clostridium difficile infections (CDI) at Norton Hospital (NH) and Norton Audubon Hospital (NAH) in Louisville, Kentucky.

METHODS: This was a multi-center, quasi-experimental study that implemented a PHHP on three units at two hospitals in the Norton Healthcare system. The sample consisted of 159 patients in the pre-intervention period and 18 patients in the intervention period. A retrospective records review was performed to analyze specific demographic variables.

RESULTS: No differences in age and gender were found between the pre-intervention and intervention groups. The groups showed no difference in gastric antacid and antibiotic usage, prior to and during admission. A control chart illustrated CDI rates between NH and NAH for a 21-month time period. Both facilities demonstrated common cause variation with no significant trends.

CONCLUSION: CDI development is multifaceted; Risks include age, diagnoses, comorbidities, and need for antibiotics. CDI rates at NH and NAH were variable and unpredictable, indicating a need for extensive research into additional preventative measures. Engaging patients and families in hand hygiene can strengthen knowledge and attitudes about hospital acquired infection prevention.