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Are you washing your hands? |
 Handwashing is considered the most important measure in preventing the spread of infection in health care establishments. However, it is known that healthcare professionals often fail to clean their hands and internationally, evidence suggests that compliance is generally below 50%.
What is being done to address poor compliance?
The “Clean Hands Saves Lives” hand hygiene campaign was launched in March 2006 in the State’s public hospitals by NSW Health and the Clinical Excellence Commission.
CEO of the commission, Prof Cliff Hughes, is a highly regarded cardiologist with a passion about clinical hygiene issues. The aim of the campaign is to reduce health care associated infections through improving hand hygiene by health care professionals, patients and visitors.
Campaign components include: observational studies on hand hygiene compliance with feedback on compliance rates; use of posters and patient information brochures to promote hand hygiene; and supply of alcohol gels to all patient care areas to facilitate frequent hand antisepsis, particularly where there is no ready access to a sink.
The benefits in using waterless alcohol gels versus handwashing at the sink include:
- less time consuming than handwashing at a sink
- faster acting
- more accessible
- more efficient in reducing bacteria and other microbes on hands
- lower skin sensitivity/reaction rate
- cost effective
In North Coast Area Health Service hospitals, hand hygiene compliance is being assessed across four health professional groups - nurses, doctors, allied health and other staff. Using an international audit tool, hand hygiene compliance is measured by comparing the number of opportunities when hand hygiene should have occurred with when hand hygiene did occur. Auditing will be conducted four times during the 12-month campaign.
Overall campaign success is being evaluated through measurement of hand hygiene compliance and multi-antibiotic resistant organism acquisition rates pre and post intervention of campaign strategies.
Hand hygiene compliance in NCAHS hospitals
Comparisons between the first two rounds of audits have shown below.
There was an improvement in hand hygiene compliance for all staff groups both before and after patient contact between Rounds 1 and 2. Doctors have demonstrated modest improvement, however overall compliance continues to remain low relative to other staff groups.
The greatest hand hygiene compliance was achieved following contact with bodily secretions where the health care professionals perceived themselves to be at risk of infection. Hand hygiene compliance before patient contact was low, suggesting a perception that hands are clean and they pose no threat to the patient.
Where to from here?
About one-third of healthcare-associated infections are thought to be preventable and poor hand hygiene is one of the major contributing factors. The challenge for health care professionals is to achieve and maintain good hand hygiene habits. Hand hygiene is a key component to ensuring both the health professional and patient are not unnecessarily exposed to potential risk of infection.
Sandra Martin is the project officer for the NCAHS’s hand hygiene campaign.
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