WHO Guidelines on Hand Hygiene in Health Care - Safe Care ...

APPENDICES
The appropriate control chart for hand hygiene compliance is
what is known as a p-chart. In this case, the “p” stands for a
percentage or proportion (i.e., the percentage of HCWs properly
cleaning their hands). There are six other basic control charts
that form the foundation for SPC analysis. Given that there
is only one way to make a run chart and many ways to make
control charts, it is advisable to start out improvement teams
by making the run chart. As they gain greater knowledge of
and comfort with statistical methods, they can move to the
application of control charts. Standard texts will provide the
reader with a full background on the theory and application of
control charts. 3-7,9-11 A good short treatment of Shewhart chart
construction can be found in Mohammed et al. 12 .
Figure 1.
Hand hygiene run chart
100
90
80
Median
70
Percentage
60
50
40
30
Lower control Limit
20
10
0
Jun-07
Jul-07
Aug-07
Sep-07
Oct-07
Nov-07
Dec-07
Jan-08
Fev-08
Mar-08
Apr-08
may-08
Jun-08
Jul-08
Aug-08
1.
Deming WE. On probability as a basis for action. The American Statistician, 1975, 29:146–152.
2.
Brooke R, Kamberg C, McGlynn E. Health system reform and quality. JAMA, 1996, 276:476–480.
3.
Lloyd RC. Quality health care: a guide to developing and using indicators. Boston, Toronto, London, Singapore, Jones and Bartlett Publishers, 2004.
4.
Shewhart WA. Economic control of quality of manufactured product. New York, NY, Van Nostrand, Inc., 1931.
5.
Wheeler DJ, Chambers DS. Understanding statistical process control. Knoxville, TN, SPC Press, 1992.
6.
Provost L, Murray S. The data guide: learning from data to improve health care. Austin, TX, Associates in Process Improvement, 2007.
7.
Grant EL, Leavenworth RS. Statistical quality control. New York, NY, McGraw-Hill, Inc.,1988.
8.
Swed FS, Eisenhart C. Tables for testing randomness of grouping in a sequence of alternatives. Annals of Mathematical Statistics, 1943, xiv:66–87
(Tables II and III).
9.
Gitlow HS et al. Tools and methods for the improvement of quality. Homewood, IL, Richard D Irwin, Inc., 1989.
10.
Carey RG, Lloyd RC. Measuring quality improvement in healthcare: a guide to statistical process control applications. Milwaukee, WI, ASQ Press, 2001.
11.
Carey RG. Improving healthcare with control charts: basic and advanced SPC methods and case studies. Milwaukee, WI, ASQ Press, 2003.
12.
Mohammed MA et al. Plotting basic control charts: tutorial notes for healthcare practitioners. Quality and Safety in Health Care, 2008, 17:137–145.
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