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Understanding Hand Hygiene Compliance In Healthcare Environments

Paul Jakeway
April 18, 2017


In the UK today, the threat of healthcare associated infections (HCAI’s) is alarming, with approximately 300,000[1] patients contracting an illness whilst being treated in healthcare premises. That accounts for a cost of around £1 billion (GBP) to an already financially strained National Health Services (NHS). It has also been revealed that patients are remaining in the hospital an extra 3.6 million days a year in the UK due to these infections[2]; meaning healthcare professionals have less time to focus on new admittances.


In a highly sensitive environment such as a hospital, risks can arise from ill patients or from surfaces and medical utensils which may contain infectious fluids. For a hospital to avoid falling victim to HCAI’s, germs and bacteria must be contained. 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 in the UK, a premature baby caught the life-threatening bacterial infection MRSA from “human to human contact."


Chief Nurse Mike Wright commented, “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, Deb is proud to be partnering with the World Health Organisation’s (WHO) ‘SAVE LIVES: Clean Your Hands’ campaign on the 5th May 2017.  This – initiative aims to drive hand hygiene awareness and engagement amongst healthcare staff in order to significantly reduce the threat of HCAI’s. 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.


How should hand hygiene compliance be monitored?


Measuring hand hygiene compliance can be difficult in healthcare environments. 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.


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, it means that staff can 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.



[1] National Institute for Healthcare & Excellence, 2011

[2] Plowman et al, 1999


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