HEALTHCARE HYGIENE CONTAINING
INFECTIONS IN HOSPITAL ENVIRONMENTS
In hospital environments, infections need to be caught fast. And Paul Jakeway, Marketing Director at Deb, believes that a proper and effective hand hygiene regimen is the first step in reducing the spread of infections.
Uniting hundreds of patients – many of them in vulnerable states – hospitals are highly sensitive environments. The containment of germs and bacteria needs to be assured at all times if a hospital wants to avoid falling victim of healthcare- associated infections (HCAIs), which are currently believed to cost the NHS around £1bn a year.
Research conducted by the European Centre for Disease Prevention and Control in 2011 showed that 6.4% of hospital patients contracted an infection while in hospital. According to the Department of Health, 300,000 patients develop a HCAI in England every year, and 5,000 of those cases are proving fatal.
But this situation isn’t inevitable – on the contrary. It is estimated that 20-40% of all HCAIs could be avoided by better communicating and applying existing hand hygiene rules and practices.
To assure the containment of germs and bacteria in hospitals hand hygiene is crucial. Given that 80% of all infections are transmitted by hands, according to research from the US Centres for Disease Control and Prevention, regular handwashing with soap is widely seen as one of the most effective ways to prevent the spread of germs and bacteria – and to avoid infections. Apart from removing visible soiling from hands, the physical action of a good handwashing technique removes high levels of bacteria and viruses that are also present on the skin.
Hand sanitising is useful in reducing bacterial counts on visibly clean heads when access to soap and running
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water is inconvenient. In contrast to soap and water, and alcohol-based sanitiser (the preferred choice in healthcare environments) kills a high proportion of the micro-organisms present on the hands, rather than to physically remove them.
Both hand washing and hand sanitising should ideally be based on the WHO Five Moments for Hand Hygiene guideline, which identifies these key moments: before patient contact; after patient contact; before an aseptic task; after exposure to body fluids; and after touching patient’s surroundings.
If a hand hygiene programme is to be complete, it should include a third element. Skin that is exposed to regular hand washing during the day needs to be replenished regularly. Restorative creams have been formulated to moisturise, nourish and condition the skin, improving its strength and preventing it from becoming dry or damaged. In hospitals and healthcare institutions, they should be used as frequently as possible.
For a hand hygiene programme to work, it is important that all three types of products – soap, sanitisers, and restorative creams – are available from easy-to-use dispensers. Modern equipment can be fully customised to suit an institution’s specific needs, while new technology such as BioCote prevents the spread of germs on the equipment – further increasing safety.
The provision of the right products should go hand-in-hand with proper staff education: it is crucial for staff to be educated about the importance of proper skin care in the workplace, and trained in using the right techniques.
This should be an ongoing conversation, rather than a one-off event.
Monitoring plays a crucial role in assuring hand hygiene compliance in hospitals – and technology has made major advances in this field in recent times. Electronic monitoring presents hospitals with an accurate, sophisticated means to effectively monitor staff behaviour.
There is no escaping the fact that traditional measures for tracking hand hygiene compliance are outdated and ineffective. Most commonly, ‘direct observation’ is used – human observers physically monitoring staff behaviour as they perform their day to day duties and determining the healthcare facility’s compliance in line with the WHO’s ‘Five moments for hand hygiene’.
The reality is that direct observation is strewn with limitations. Observational programmes are typically conducted manually, with limited sophistication in the gathering or analysis of the data compiled – but that is just the start of the associated problems.
By being under such obvious scrutiny it is common for the ‘Hawthorne Effect’ to manifest itself, by which medical staff will be aware that they are being watched and will exhibit different behaviour to that which they would normally. As a result, compliance rates are artificially high and not a true reflection of actual hand hygiene habits.
The statistical reliability is hampered further still, quite simply because it is impossible to gather sample sizes that reflect the entire operation. Observers cannot monitor every interaction between doctors and nurses with
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