Infection control
Helping hands
While the pandemic has brought hand hygiene front of mind for healthcare professionals and the public alike, it’s not yet clear if it will prompt any lasting changes in attitudes and behaviours. Monica Karpinski talks to Rachel Ben Salem, deputy director for infection prevention control and head of nursing at King’s College Hospital; Dr Mamdooh Alzyood, infection prevention specialist and public health lecturer at Oxford Brookes University; and Dr Manjula Meda, consultant clinical microbiologist and infection control doctor at Frimley Park Hospital in Surrey, about what can be done to encourage hand hygiene compliance among healthcare workers.
doctor not washing their hands at work is like a driver reversing into the road without checking their mirrors. At least that’s the point of view of Rachel Ben Salem, deputy director for infection prevention control and head of nursing at King’s College Hospital. “Without safety checks, you’re calling for a crash,” she says.
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Reminders to wash your hands thoroughly and often became an unavoidable aspect of public health messaging during the pandemic, but that shouldn’t have been news to anyone. Hand hygiene has long been regarded as one of the main defences against the spread of infectious diseases. Our hands can be carriers for transmissible organisms, including the Covid-19 virus, which can be removed with thorough cleaning. But hand hygiene compliance is not as simple as it seems, says infection prevention specialist and public health lecturer at Oxford Brookes University, Dr Mamdooh Alzyood. Healthcare staff may well be exposed to continual reminders to wash their hands, but whether they do it or not is impacted by a range of factors – from the culture within their workplace to what feels ‘normal’ to them.
For the levels of compliance seen during the pandemic to last, there needs to be a wider shift in norms surrounding hygiene. “Hand hygiene is not only a procedure; it is a culture,” says Alzyood. “We need to adopt a culture of hygiene. We are not there yet.”
Practical Patient Care /
www.practical-patient-care.com Changed attitudes
Clinical guidance for when healthcare workers should wash their hands hasn’t changed on account of the pandemic. It’s simply being taken more seriously. Published by the WHO, the guidance outlines five points when healthcare professionals should clean their hands: before touching a patient; before a clean/ aseptic procedure; after any risk of being exposed to body fluid; after patient contact; and after touching a patient’s surroundings, such as their hospital bed. Health professionals have certainly become more aware of these rules and increased their compliance, but both Ben Salem and Alzyood express concern that staff will revert to ‘normal’ once the pandemic is over. “[During] any health campaign, hospital accreditation or safety audit, hand hygiene compliance is perfect,” says Alzyood. “Especially during a hospital accreditation – [staff] know that infection control agents are coming. But after that, we go back to normal.” This echoes Ben Salem’s experience monitoring and auditing levels of hand hygiene within her hospital as an infection control nurse. “If I come in to inspect the wards, everybody changes their behaviour. Everyone will clean their hands because they’ve seen that I’m watching them, and I’ve seen that happen time and time again,” she says.
Hypervigilance and anxiety about the pandemic have also caused some professionals to overwash their hands
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