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Lend a Helping Hand, but Only if it’s Clean!

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THE PROBLEM

Studies have shown that only half of healthcare professionals adequately follow hand hygiene protocols in place. This seems like a pretty shocking statistic, when you consider the industry this issue is occurring in.

Healthcare professionals that fail to wash their hands frequently and correctly throughout their shifts, could be contributing to the spread of healthcare-associated infections (HCAIs) that affect 1 in 31 hospital patients on any given day, according to the CDC. Infections like Staphylococcus aureus (Staph, including MRSA), and Streptococcus pyogenes (Group A Strep) are a few of common infections that can spread from the hands of healthcare professionals.

A majority of HCAIs are contracted during care or treatment in a healthcare facility. Hands can be contaminated from the most basic patient interactions from taking a pulse to touching a patient’s shoulder. These infections can hinder recovery and prolong treatment plans for patients, increase medical costs and hospital stays, and can even be life-threatening.  HCAIs tend to affect vulnerable patients in hospitals, especially babies. According to the Global Handwashing Partnership, as many as 56% of neonatal deaths among babies born in hospitals can be attributed to infection.

Low compliance to hand hygiene standards can negatively impact a hospital’s ability to offer safe services in a clean environment. Infection prevention and control, like hand washing, is the most basic way for improving quality care not only babies, but all patients in  healthcare facilities.

 

THE GUIDELINES

Hospitals and health systems have been required to have a hand hygiene program in place for more than ten years, with many standards being set in place by the CDC and the World Health Organization (WHO).  

According to the WHO, Healthcare Administrators must provide the following to their workers:

  • Access to a safe, continuous water supply at all outlets and access to the necessary facilities to perform hand washing
  • A readily accessible alcohol-based hand sanitizer at the point of patient care
  • Ensure that HCWs have dedicated time for infection control training, including sessions on hand hygiene
  • Ensure that the water supply is physically separated from drainage and sewerage within the healthcare setting and provide routine system monitoring and management
  • Additional items like sterile gloves must be provided for HCPs to combat the spread of infections.

Joint Commission, a non-profit organization that accredits more than 21,000 US health care organizations and programs, including Preferred Healthcare Staffing, has considered hand hygiene for accreditation since 2004. Effective since Jan. 1, 2018, the Joint Commission issues a citation to healthcare organizations if they witness an employee failing to follow correct hand hygiene guidelines during on-site visits. The Commission advocates for proper hand hygiene training of employees by the facility, as well as fostering a culture of holding each other accountable to following procedures.

 

BARRIERS TO SUCCESS

Anyone who has taken a science class knows that washing hands helps prevent the spread of germs, so why is this problem still occurring, especially in healthcare? Many studies have shown that although it’s largely on the HCPs, there are several factors that may impact an HCPs ability to comply with hand washing standards.

Accessibility

Although access to a continuous water supply for hand washing is given to HCPs, it’s often in inconvenient locations, far from patient treatment areas. Additionally, facilities may not keep with the supply and demand, often leaving hand sanitizer and soap dispensers empty when workers need it.

Irritation

Frequent hand washing can often lead to chafing, cracked, or burning skin, called irritant contact dermatitis. Because the soap strips your skin of natural oils, it often results in these effects. Alcohol-based hand sanitizers may be the best alternative for hand washing, since it’s less likely to cause dryness and irritation.

Resistance

According to researchers at the University of Michigan, healthcare organizations often have employees who are simply resistant to procedures. Active resisters are people who like doing things a certain way for the simple reason that things have always been done that way. On the other hand, organizational conspirators are those who often have nothing against an initiative per se but simply enjoy exercising their power by refusing to change, albeit below the radar. Both types of resistance may make it hard to implement change throughout the organization.

 

WHAT FACILITIES CAN DO

Adhere to CDC and WHO Standards

Continuing to provide access to safe water supplies and hand sanitizers is crucial to a hand hygiene program’s success. Alcohol-based solutions are the most effective in killing germs and is often the most preferred method in healthcare settings.

Hold Workers Responsible

By implementing continuous education on the importance of hand washing and methods, this can help shape the hygiene culture at the facility. Observation and feedback can also be successful. For example, according to researchers, one intensive care unit installed video cameras located by sinks and hand sanitizer dispensers found that healthcare professionals were 8 times more likely to comply with hand hygiene requirements when remote video auditing was combined with data feedback.

Encourage and Empower

Encouraging professionals in the facility to adhere to hand hygiene standards likely leads to ambassadors of the act inside and outside of the settings. Distributing essential products, like hand sanitizer, for HCPs to share with their patients and friends may also reinforce the importance of handwashing.

 

WHAT CAN PROVIDERS DO

Many patients may carry microbes without any obvious signs or symptoms of an infection, which should reinforce the need for hand washing by providers. The CDC recommends Healthcare providers clean their hands before and after every patient contact to protect themselves as well as their patients from infections. Often this can be as many as 100 to 200 times per shift.

 

 

 

 

 

 

 

 

 

 

Image courtesy of the CDC

 

WHAT CAN PATIENTS DO

Spreading germs can go both ways. While providers are responsible for providing care to their patients with clean hands, patients also play a role in preventing the spread of infection. Patients should frequently wash their own hands with soap and water or hand sanitizer and ask that their visitors do the same.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Image courtesy of the CDC

 

It’s clear that there are many reasons why hand hygiene has become such a complex issue. However, it’s clear that this simple act can have a lasting impact on the hospital environment and plays a key role in preventing the spread of many illnesses and infections. As a healthcare provider, how you have held yourself to a high standard when it comes to the frequency and effectiveness of washing your hands during your shift? 

 

Sources:

https://globalhandwashing.org/wp-content/uploads/2017/08/GHP-Hygiene-in-HCFs-Fact-Sheet-Aug2017.pdf

https://labblog.uofmhealth.org/industry-dx/hand-washing-stops-infections-so-why-do-health-care-workers-skip-it

https://www.modernhealthcare.com/article/20180103/NEWS/180109976/joint-commission-cracks-down-on-hand-hygiene

https://www.cdc.gov/features/handhygiene/index.html

https://www.infectioncontroltoday.com/hand-hygiene/hand-hygiene-compliance-monitoring-provides-benefits-challenges

https://www.who.int/gpsc/tools/faqs/evidence_hand_hygiene/en/

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