Handwashing: The Life You Save May Be Your Own

An Ounce of Prevention,
Handwashing: The Life You Save May Be Your Own

When it comes to the prevention and control of infections, the best advice I can give you is advice your mother gave you as a child: “Wash your hands!”

And, if you ever find yourself hospitalized, ask that staffers wash or sanitize their hands while you watch. A recent survey of doctors and nurses said they would respond positively if you asked them to wash their hands in your presence, but felt uncomfortable that you would ask in the first place!

But, here’s the rub (pardon the pun) … People who use public restrooms are more likely to wash their hands than physicians in America’s hospitals, a leading scholar reports.

“As a concept, [the health care workers] agreed, but many feared it would negatively impact [the] health care worker-patient relationship”, said Dr. Yves Longtin of the Geneva University Hospital. “For example, some said admission of failure to comply with handwashing protocols could lead to legal action.”

But, some hospitals are taking matters into their own hands (pardon another pun). Employees with patient care relationships at Abington Memorial Hospital could soon find themselves out of a job if they don’t follow hospital policy on handwashing. The employees administering patient care are casually observed by “secret shoppers” to see whether or not they are complying with the “zero tolerance” policy for failure to wash their hands before and after they enter a patient’s room.

In December 2007, handwashing compliance stood at a meager 31 percent, with physicians being the least compliant. It took the director of Abingdon Memorial’s epidemiology department educating the chronic offending physicians (doctor to doctor) to turn a corner in compliance. With other interventions by the hospital’s leadership, they saw compliance climb and then plateau at 88 percent and saw a commensurate drop in infections.

So, due to a recent drop in handwashing compliance, the hospital will institute a system of potential rewards and punishments. Compliant handwashers will receive index cards that make them eligible for a prize raffle; noncompliant employees will receive index cards with an infraction notice. Staff members who reach three infractions will receive a letter noting that reappointment is conditional. The hospital reappoints employees every two years.

Poor handwashing could result in dismissal; it’s serious stuff! What’s more serious than somebody dying from a hospital-acquired infection that could have been prevented with proper hand washing?

In your experience in hospitals, do you believe that fewer than 50 percent of patient caregivers perform proper handwashing?

Darrel Hicks is the environmental services director at St. Luke's Hospital. A frequent contributor to trade publications, Hicks is the author of “Infection Prevention For Dummies,” which is now in its second edition. Hicks is available for on-site consultation with your staff. For more information, visit www.DarrelHicks.com.