A HELPING HAND
We talked to John Hines, Research and Development Director at hand hygiene expert Deb, about the impact of effective infection prevention in healthcare facilities, and why hand hygiene compliance – driven by its pioneering DebMed programme – is the key to saving patients’ lives.
What are the biggest problems with hand hygiene
compliance today? Hand hygiene is crucial to the management of micro-organisms in hospitals — with up to 80% of all healthcare-associated infections (HCAIs) estimated by the US Centers of Disease Control and Prevention to be transmitted by healthcare workers’ hands. Unfortunately, many healthcare organisations are failing to maintain their compliance rates.
A major issue for them is not having the ability to monitor staff behaviour and hand hygiene procedures effectively. Take direct observation, for example: it’s the most common auditing method, but has severe limitations.
Programmes are typically conducted manually, with limited sophistication in the gathering or analysis of the data compiled. Some online auditing tools are becoming available, but don’t overcome the fundamental flaws in this approach.
36 | HEALTHCARE HYGIENE
First is the ‘Hawthorne Effect’: staff know when they are being monitored and behave differently. These observed compliance rates are artificial, giving hospitals a false reflection of actual hand hygiene habits (and how to improve them). Often, this method of reporting will only capture room entry and exit events, and can also overstate actual compliance by up to 300%.
Another issue is that by using direct observation, it’s impossible to gather sufficient data to adequately reflect true practice. Observers often monitor a given ward or unit for only 30 minutes/an hour per month, and typically observations only take place during the day.
Ultimately, hospitals just do not have the resources to overcome the issues with direct observation. That is why I absolutely believe that technology will be the key to improving the level of care provided in healthcare environments – and preventing the spread of infections across hospitals.
How badly can non- compliance affect healthcare
institutions? HCAIs cost the NHS in the region of £1bn every year. And failing to effectively prevent infections in healthcare environments can also mean that patients have to stay in hospital for longer. This means that patients are remaining in hospital an extra 3.6 million days a year in the UK due to infections, leaving less time and resources to focus on new admittances.
The debate around infection control is also happening at a time when the healthcare sector has a close eye on the growing threat from anti-microbial resistance (AMR). Around 700,000 people around the world die each year due to AMR, while the World Health Organisation (WHO) survey on AMR confirms that resistance is frequent in bacteria isolated in healthcare facilities.
For instance, with MRSA, it is as high as 44%, 40% and 38% on average in Latin America, West African
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