Quebec study found healthcare workers only washed their hands 28% of the time when coming and going from patient rooms

Researchers in Québec were able to focus on hand hygiene compliance of individual nurses using an automated electronic monitoring system. They found that healthcare workers washed their hands 28% of the time as they entered and left patient rooms. The results suggest that an automatic method to monitor hand washing could increase compliance of individual nurses. “Currently, compliance with hand hygiene rules by healthcare staff is suboptimal, and it’s time to consider new strategies if we are to counter the transmission of nosocomial infections more effectively. Automated systems that measure caregiver compliance with these rules and provide individualized feedback focused on improving care could be part of the solution,” said Dr. Maxime-Antoine Tremblay in a University of Laval press release. Dr. Tremblay is lead author of the study and an infectious disease physician at Centre Hospitalier de Québec -Université de Laval. The pilot study involved 10 hospital rooms at a Montreal hospital. The automated system recorded the number of entries and exits into each room, and the number of times the automatic hand sanitizer or soap dispenser was used. By matching the data with the shifts each nurse was working, the researchers could analyze each nurses’ hand hygiene performance. Read: Why serious kidney disease occurring in some Calgary kids infected with E. coli Over three months, there were 135,546 entries and exits into the rooms, but the hand sanitizer or soap dispenser was only activated 38, 596 times, or 28% of time. Previous reports from the same hospital cited a 72% compliance with hand hygiene, Dr. Tremblay noted. Those studies had not used an automated system. Ten of the 54 nurses assigned to the hospital rooms had better median hand hygiene statistics in the rooms they covered compared to the group average, but nine had worse statistics than the group average. Using a negative binomial model, researchers identified 15 high hand hygiene performers and 16 poor hand hygiene performers. Hospital staff should disinfect their hands before and after any contact with a patient. Assessing compliance is often done by human observers, but results could be biased by the Hawthorne effect, where people being observed change their behaviours. Also, studies using observers usually provide hospital-wide data and don’t narrow in on individuals who aren’t washing hands enough, Dr. Tremblay noted. “In Quebec, awareness campaigns in hospitals have led to considerable progress over the last few decades. However, in recent years, compliance has plateaued. It fluctuates between 40% and 80%, depending on the hospital,” Dr. Tremblay said. Future strategies to improve hand-washing could be focused on individuals, not just hospital-wide campaigns, Dr. Tremblay said. “An automated system implemented with a positive feedback perspective should be well accepted by nursing staff because its aim is not to punish, but to improve patient care,” he said. The paper was published in the American Journal of Infection Control. Dr. Tremblay’s quotes were translated from French. Read: The fungus zombies in ‘The Last of Us’ are fictional, but real fungi can infect people, and they’re becoming more resistant

Quebec study found healthcare workers only washed their hands 28% of the time when coming and going from patient rooms

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