It's no secret that hand hygiene compliance rates in healthcare are abysmally low; a study published in the American Journal of Medical Quality in 2009 suggests hand hygiene occurs at or below 50 percent compliance for both ICUs and non-ICUs in the U.S. But the following 10 developments covered by Becker's Infection Control & Quality may help experts get one step closer to discovering why that is and what can be done to mitigate the problem.
1. A report from The Leapfrog Group based on data taken from the 2014 Leapfrog Hospital Survey of 1,501 U.S. hospitals revealed that one in four still have not implemented all the safe practices and policies recommended for proper hand hygiene. Some examples of Leapfrog's standards include having hospitalwide hand hygiene education and training, submitting hand hygiene recommendations and results to the hospital board, holding clinical leadership accountable for compliance and implementing performance improvement programs. Additionally, the data showed urban hospitals outperformed rural hospitals for the fifth consecutive year; with about 20 percent more urban hospitals than rural hospitals meet Leapfrog's standard and showing greater year-over-year improvement.
2. Researchers found that a lack of standardization in how hand hygiene-related solutions are arranged at hospital emergency department washbasins may have an effect on performance, in a study published in the American Journal of Infection Control. By standardizing the relative location of handwash solutions, such as soap on one side and hand drying agents on the other, hospitals may be able to improve hand hygiene behaviors.
3. Senior health professionals and mentors play an important role in improving hand hygiene compliance, according to a study published in Infection Control & Hospital Epidemiology. For instance, compliance among medical students and healthcare workers in one study was marginally higher among those whose leaders practiced hand hygiene (71 percent) than among groups whose leaders did not (29 percent).
4. A study in the American Journal of Infection Control revealed that healthcare workers touch their faces multiple times each hour, a habit that could spread germs if hand hygiene compliance is not met. By raising awareness of this habit and its effects, hospitals may be able to improve hand hygiene compliance.
5. The Joint Commission Center for Transforming Healthcare started a patient safety project on hand hygiene in 2008, putting together teams in eight hospitals. Ultimately, the teams found that a targeted approach to hand hygiene improvement — focusing improvement efforts on specific issues of noncompliance — can be more effective than a "one-size-fits-all" strategy.
6. In an informal survey conducted by Mundelein, Ill.-based Medline's online clinical education resource, most of the nurses surveyed — 44.5 percent — indicated their hands felt dry and itchy during a regular shift. What's more, 13.9 percent of surveyed nurses said they have considered leaving the healthcare field due to dry, irritated or damaged hands. Improving hand hygiene compliance will undoubtedly mean addressing these issues.
7. When implementing a hand hygiene program, researchers suggest emphasizing continuous monitoring and immediate feedback to help increase compliance rates, according to a study in American Journal of Infection Control. In the study, a hospital improved hand hygiene compliance by 41 percent in one unit and 36 percent in another by focusing on these areas.
8. Healthcare workers are less likely to comply with hand hygiene standards at the end of a shift, particularly if it was a long shift, according to research published in The Journal of Applied Psychology. Although the study found that hand hygiene compliance rates dropped by 8.7 percentage points on average from the beginning to the end of a typical, 12-hour work shift, the effect was mitigated by longer breaks between shifts.
9. A study in the American Journal of Infection Control found a change as simple as installing bright red hand sanitizer dispensers can increase hand hygiene compliance in hospitals. In fact, healthcare worker-adjusted compliance increased by 6 percent once the red dispensers were installed at the hospital in Germany where the study took place.
10. Bright red hand sanitizer dispensers aren't the only tool hospitals can use to improve hand hygiene; compliance rates at one hospital roughly doubled after flashing red lights were placed on hand sanitizer dispensers, a study published in the American Journal of Infection Control found.
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