Handwashing compliance lower than stated: study

CHARLOTTE, N.C. – A DebMed-sponsored survey of handwashing practices in Canadian hospitals reveals that despite the prevalence of available electronic technologies, manual methods are still predominately used for tracking hand hygiene. According to the company, that is leading to inconsistency in hand hygiene compliance reporting and leaves patients and clinical staff at risk for infection.

The survey gathered responses from more than 130 infection preventionists, nurses and other healthcare leaders in Canadian hospitals. DebMed is the healthcare program of the Deb Group. The DebMed program offers hand hygiene products, electronic monitoring technology, and improvement tools to support hand hygiene compliance.

Key findings include:

•  68 percent of respondents said their facility reports hand hygiene compliance to be 71 percent or greater, however,
•  67 percent believe that their true hand hygiene compliance is actually 70 percent or less.
•  Only 25 percent of those surveyed said they are “extremely satisfied” by the reliability of their facility’s hand hygiene compliance data.

The survey also found that there are significant inconsistencies between healthcare workers’ beliefs, and the actual practices of hand hygiene compliance in their facilities:

•  61 percent believe electronic hand hygiene compliance monitoring is a more accurate option than direct observation.
•  92 percent of respondents currently use direct observation to measure and report hand hygiene compliance in their facility, while 3 percent use electronic monitoring.

With that said, 82 percent believe the Hawthorne effect, which states that people will change their behavior if they know they are being watched, impacts the accuracy of reported hand hygiene compliance rates by overinflating it. The numbers show a positive trend toward electronic technology awareness and adoption, yet budgetary restrictions are an obstacle for implementation.

Still, 80 percent of respondents said their facility’s CEO would include reducing patient infections through increased hand hygiene compliance as a top priority. As such:

•  35 percent are currently considering an electronic hand hygiene monitoring system.
•  25 percent say their facility intends on purchasing an electronic hand hygiene monitoring system in the next 12+ months.
•  86 percent say their facility currently does not have a budget allocated for the purchase of an electronic hand hygiene monitoring system, though 6 percent do plan on including it in their next budget cycle.

“The survey results accurately represent the challenges the industry faces in regard to clean hands and safer care for patients,” said Heather McLarney (pictured), vice president of marketing, DebMed North America. “The numbers confirm what we hear firsthand from infection preventionists. They and other hospital staff want to implement the best hand hygiene practices for improved patient safety and health, but they face the reality of a host of other IT priorities competing for funding and focus.”

Further, the survey findings cite the oft-used “in and out” method of only cleaning hands before and after patient interaction still reigns at most facilities, despite the fact that data shows additional hand cleaning – such as after touching a bed rail or medical chart – lowers infection rates.

•  91 percent believe the WHO Four Moments and Centers for Disease Control and Prevention Guidelines (CDC) are a higher clinical standard that help reduce the spread of infections better than cleaning hands only before and after patient care.
•  72 percent teach staff to follow the WHO and CDC hand hygiene guidelines, but a majority (58 percent) only clean hands when entering and exiting patient rooms.

“As this is our first year completing a survey of Canadian healthcare workers on hand hygiene, it will be particularly interesting to see how trends change and take shape over the coming years following this initial collection of information,” said McLarney.

“We will continue to push for improved hand hygiene compliance monitoring to dramatically increase patient safety and care at a time when we are still seeing outbreaks of infections that can be controlled in part by proper hand hygiene.”

DebMed is the creator of the world’s first electronic hand hygiene compliance monitoring system based on the WHO’s Four Moments for Hand Hygiene and CDC hand hygiene compliance standards. For more information, visit www.debmed.com.