Comment: Hand hygiene compliance and its impact on infection control in healthcare environments

Paul Jakeway of Deb explains why it is crucial that healthcare stakeholders are focused on fighting antibiotic resistance, and why electronic monitoring is the answer

A lack of hand hygiene compliance by healthcare staff continues to be a significant contributor to the spread of pathogens, resulting in healthcare associated infections (HCAIs).

The threat of HCAIs is alarming, with approximately 300,000 patients contracting an illness while being treated in healthcare premises.

New ways of reporting hand hygiene compliance have been developed to ensure that workers are held accountable for delivering the safe, high-quality care that the NHS is renowned for worldwide

HCAI’s are not only a persistent threat to patient safety – patients are also forced to remain in hospital for an extra 3.6 million days a year in the UK due to these infections, and they cost the already-financially-strained NHS £1billion.

In a highly-sensitive environment such as a hospital, risks can arise from sick patients or from surfaces and medical utensils which contain fluids that are infectious.

For a hospital to avoid falling victim to HCAIs, germs and bacteria must be contained.

The answer is electronic monitoring – a cost-effective method that is considerably more reliable than direct monitoring, and can capture 100% of hand hygiene events, providing operators with precise, quantitative data on actual hand hygiene compliance

Poor infection control can have a devastating impact. It was revealed earlier this year that in the Neonatal Intensive Care Unit (NICU) of Hull’s Women and Children’s Hospital, a premature baby caught the life-threatening bacterial infection MRSA from ‘human-to-human contact’.

Chief nurse, Mike Wright, said at the time: “We can confirm there was a lapse in infection prevention and control practice, which resulted in likely human-to-human transmission on our Neonatal Intensive Care Unit, and this is deeply regrettable.”

Fortunately in this case, the premature baby survived and made a full recovery, but the seriousness of this case conveys how incredibly important effective infection prevention is.

To help reduce the risk of infection in healthcare environments, the World Health Organisation (WHO) has created the SAVE LIVES: Clean Your Hands campaign, an initiative with the aim to drive hand hygiene awareness and engagement among healthcare staff in order to significantly reduce the threat of HCAIs.

It is crucial that healthcare stakeholders are focused on fighting antibiotic resistance in healthcare environments. This can be combatted by effectively cleaning the hands at critical times.

The WHO has recommended that healthcare employees follow its ‘5 Moments for Hand Hygiene’, which outlines that healthcare employees must wash their hands before touching a patient, before clean or aseptic procedures, after body fluid exposure or risk, after touching a patient, and after touching patient surroundings.

Monitoring

Measuring hand hygiene compliance can be difficult in healthcare environments.

It is possible to monitor what is happening more accurately and determine whether it falls in line with compliance standards

New ways of reporting have been developed to ensure that workers are held accountable for delivering the safe, high-quality care that the NHS is renowned for worldwide.

In many cases, reported hand hygiene rates are much higher than the actual rate of compliance, due to the inaccurate methods of gathering data.

The common method of using direct observation to measure hand compliance is deeply flawed.

The information can be subjective, imprecise, and prone to false positives.

For staff, knowing when they are being watched might make them overplay their regular habits, running their hand under a sanitising dispenser more frequently than they might normally – this behaviour is commonly known as the Hawthorne effect.

The answer is electronic monitoring – a cost-effective method that is considerably more reliable than direct monitoring, and can capture 100% of hand hygiene events, providing operators with precise, quantitative data on actual hand hygiene compliance.

The system can also be established into a healthcare environment in a way that bears no detrimental impact to the daily activities of medical staff.

State-of-the-art electronic numeration can be incorporated into the dispensers, meaning that a wireless signal will activate any time the dispenser is used and be sent to a tracking server.

Through having the available numerical data, staff are able to collaborate on compliance improvement plans, set goals, and ensure that, as a team, they are doing everything in their power to improve hand hygiene, and thus patient safety

It is then possible to monitor what is happening more accurately and determine whether it falls in line with compliance standards.

Through having the available numerical data, staff are able to collaborate on compliance improvement plans, set goals, and ensure that, as a team, they are doing everything in their power to improve hand hygiene, and thus patient safety.

The difference that hand hygiene compliance can make in healthcare environments is incalculable.

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