What's holding us back from handwashing?

By Healthcare Facilities Today
October 25, 2013

Ellen Hargett, RN, director of process improvement at Atlanta's DeKalb Regional Health System, contracted a severe case of methicillin-resistant Staphylococcus aureus, a bacteria often transmitted through improper hand hygiene, after surgery. She battled sepsis and an abdominal abscess for many months following the surgery. Ultimately, she was informed her last option was another surgery that would leave her abdomen open for a week. It saved her life, according to an article on the Becker's Hospital Review website.

While recuperaating, she began an informal tally of infection control opportunities. "I noticed it was about 30 percent of the time that people carried out elements of infection prevention [including hand hygiene]," she says. "Later I learned that standard of performance was not unique to our hospital."

Didier Pittet, MD, director of the infection control program and the Collaborating Center for Patient Safety at the World Health Organization, said in the article that Hargett's story is not uncommon. Pittet lead the team that developed the 2005 internationally-utilized WHO tool, "My Five Moments for Hand Hygiene." 

Unfortunately, hospital-acquired infections are a daily reality in healthcare settings. In the U.S. alone there are nearly 100,000 HAIs creating $35 billion to $45 billion in extra costs to the healthcare system. Worldwide, 15 million patients die from HAIs every year. These statistics, according to Pittet, are exactly why hand hygiene is priority for the WHO, the article said.

The "My Five Moments for Hand Hygiene" program is in place in more than 170 countries worldwide, and it has proven effective in every country and culture, according to the article. It recommends healthcare workers clean hands before touching a patient, before aseptic procedures, after body fluid exposure or risk of exposure, after touching a patient and after touching patient surroundings.

Despite its potential effectiveness, the program suffers from low compliance — between 10 and 40 percent. This is a known effect: Healthcare workers imagine hand hygiene compliance twice as good as the reality. According to Pittet, this is because hospitals are simply not ready to commit to safety cultures that help healthcare workers have consistently great hand hygiene compliance.

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