Date of Graduation

Winter 12-13-2019

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor

Carla S. Martin MSN, RN, CIC, CNL


The street nurse team of Sacramento, CA provides many services to patients who are experiencing homelessness, including a substantial amount of wound care. While the street nurses were performing hand hygiene (HH) prior to and after wound care, they would often not be performing it immediately prior and post-wound care. Because the nurses hike to their patients (who are living on the streets or in out of the way camps) the street nurses would often perform hand hygiene while at their cars prior to going to the patient and again when they returned to their cars after performing wound care. When monitoring the amount of wound care done immediately pre- and post- wound care, the rate was only 20%. This project aims to increase the rate of hand hygiene by the street nurses to 90% by December of 2019 by making simple improvements to the street nurse work process. The results of the project showed a dramatic improvement in hand hygiene. Four weeks into the project, and the rate of hand hygiene is up to 90%. Other unexpected benefits to the program included increased patient education by the street nurses regarding wound care, an increased amount of hand sanitizer passed out to patients, and improved job satisfaction by the street nurses.