To determine the improvement of hand hygiene and personal protective equipment adherence rate in the emergency department through quality improvement study.

The purpose of this study is to assess the improvement in Hand Hygiene and Personal Protective Equipment (PPE) adherence rates through a Quality Improvement (QI) initiative. The QI study will span a total of 15 months, consisting of 1 month for baseline data collection, 12 months for the intervention phase, and 2 months for the sustainability phase. During the baseline phase, data on the Hand Hygiene and PPE adherence rates among doctors and nursing officers will be collected before any interventions are implemented. This data will be gathered from different zones of the Emergency Department over a period of 40 minutes daily for 20 days within the month. Data collection will be conducted using the IBHAR app and Google Forms, and the data will be analyzed accordingly. A core QI team will be formed, which will include the Principal Investigator, Guides, Co-Guides, Senior and Junior Residents, and Senior Nursing Officers. The QI team will evaluate the baseline data and use a fishbone diagram to investigate the causes and effects of adherence issues. The pre-planned interventions will include on-site feedback, monthly audits of hand hygiene and PPE adherence, circulation of audit results, reinforcement strategies, educational sessions, and online pre- and post-test assessments. These interventions will be adjusted based on ongoing assessments during the intervention phase and feedback from the QI team. The monthly audits have been designed to analyze data regularly and to reinforce Hand Hygiene and PPE adherence. After the 12-month intervention phase, a sustainability phase will be implemented to evaluate the effectiveness of these interventions. The collected data will be analyzed, and the final outcomes of the study will be reported.