Why can't we seem to say goodbye to poor hand hygiene

We know washing our hands is good practice. We know it’s one of the most effective ways to prevent the spread of infections within healthcare settings. So why is hand hygiene compliance still an issue?

According to an American Hospital Association publication, there are ten primary causes of poor hand hygiene:

1. Ineffective placement of dispensers or sinks.
2. Hand hygiene compliance data are not collected or reported accurately or frequently enough.
3. Lack of accountability and just-in-time coaching.
4. The safety culture does not stress hand hygiene at all levels.
5. Ineffective or insufficient education.
6. Health providers, such as those carrying supplies, have their hands full.
7. Wearing gloves that interfere with hand hygiene.
8. The perception that hand hygiene is not needed if wearing gloves.
9. Healthcare workers forget to perform hand hygiene.
10. Distractions.
     

The Centers for Disease Control and Prevention (CDC) reports that some healthcare providers clean their hands less than half the times they should. Why? It might have something to do with the number of times a healthcare worker is ‘supposed’ to wash their hands in a day when following proper infection prevention practices. According to the World Health Organization’s (WHO) ‘My 5 Moments for Hand Hygiene’ healthcare workers must wash their hands in each the following situations:

1. Before touching a patient.
2. Before any procedure.
3. After bodily fluid exposure.
4. After touching a patient.
5. After touching a patient’s surroundings.
    

That seems like a lot of handwashing considering the number of patients a healthcare worker in a high-acuity unit interacts with during a shift. With this list of reasons for poor hand hygiene, it doesn’t seem that surprising why hand hygiene might still be an issue.

Fortunately, there are products and systems on the market to help make this task as easy as possible for healthcare professionals. First is the acceptance of alcohol-based handrubs as an effective means of handwashing over the past few years. In fact, according to the CDC, alcohol-based handrubs are now the preferred method for hand cleaning within healthcare facilities (except in cases of C. difficile) because of their effectiveness at killing potentially deadly germs on hands in less time and, with some products, added moisturisers to protect the skin from drying, such as Cutan Alcohol Foam antiseptic handrubs.

Second is the addition of consistent education and reminders that can be included around the hospital to help remind healthcare workers to wash their hands. These reminders can help keep hand hygiene at the forefront of a healthcare worker’s mind.

While the standards and opportunities for hand hygiene remain the same in healthcare, the availability of more efficient products and programs have made it an easier task for staff to comply with. Proper hand hygiene and sustained compliance are necessary when working in healthcare to ensure the health and safety of staff and patients. It is well known that hand hygiene has an enormous impact on patient safety and the performance of the hospital, so following all 5 Moments is the first step in overcoming poor hand hygiene practices.

Image courtesy of SC Johnson Professional.