Hand washing may seem like a simple task the youngest of school children are taught to wash their hands while singing the Happy Birthday song twice to ensure they do it well enough to prevent spreading infection. But adults seem to still be struggling with it, according to recent reports.
One-fifth to one-third of health care agencies in nursing and rehabilitation, home health and long-term transitional care surveyed for accreditation by The Joint Commission in the first half of 2013 failed to adhere to hand-hygiene guidelines as outlined by either the U.S. Centers for Disease Control and Prevention or the World Health Organization.
The Commission, one of the largest health care accrediting organizations in the nation, released its bi-annual list of most challenging requirements for various types of facilities last week.
According to the Commission, 22% of nursing and rehabilitation centers, 25% of home care organizations and 33% of Medicare/Medicaid-certified long-term care programs (transitioning patients into nursing and rehabilitation centers) failed to meet the hand hygiene standard under the commissions National Patient Safety Goal on health care-acquired infections.
In general, CDC guidelines include decontaminating the hands before having direct contact with patients; before donning sterile gloves when inserting catheters or other invasive devices; after taking pulse, blood pressure or lifting a patient; after contact with bodily fluids or excretions; after removing gloves and before eating and after using a restroom. (The specific guidelines can be found on the CDCs hand hygiene website.)
The good news is that a study in Canada has shown that electronic monitoring can greatly improve hand hygiene. In the study, nurses were provided badges that would provide an electronic reminder of instances when hand washing was required. According to a report by Fierce Health IT, nurses in the first stage of the study were washing their hands only about a third of the time. Once the reminder function was turned on, the compliance rate doubled.
Of course, that still means that hands were not washed one-third of the time. (A suggestion: Perhaps the electronic reminder could somehow feature the Happy Birthday tune.)