Infection control
hygiene services, such as hand washing facilities with water and alcohol-based hand rubs, were available in areas where patients receive care, and toilets. The report calculated that an estimated 3.85 billion worldwide use healthcare facilities and it is common knowledge that infections are more likely to be contracted in these settings.
Tackling challenges in hand hygiene compliance
Empowering healthcare workers with proper hand hygiene practices can help to break the infection chain and safeguard patients.
3.85bn
The total number of healthcare facilities used worldwide, where half lack the basic hygiene services and risk infection.
WHO 42
As Dr Janet Glowicz, an infection preventionist |at the Centers for Disease Control and Promotion’s Division of Healthcare Quality Promotion, explains how poor hand hygiene is one of the key factors contributing to the transmission of infections in healthcare facilities: “The hands of healthcare workers can easily spread infections in healthcare facilities. Very brief contact with surfaces in the patient environment, like bed rails, can allow germs to hitch a ride on the hands of healthcare workers and travel from one patient to the next.” Infections that are transmitted as a result of poor hand hygiene are not necessarily being transmitted by skin-to-skin contact. “Also, people receiving care often have medical devices, like IVs, that might allow germs to enter their bodies,” continues Glowicz “There may be different germs in a healthcare facility than in the community, and there may be higher chances of encountering drug-resistant germs inside healthcare facilities.” But just as important as practising hand hygiene is educating and promoting it. “Education and training for hand hygiene compliance and quality is very important and should be intended to not only improve healthcare providers’ practice but should also improve their attitude and morale towards patient safety,” explains Dr Shanina Knighton, associate professor at Case Western Reserve University and expert on infection prevention. In a post-Covid-19 era, governments and healthcare organisations have become increasingly aware of the impact of HAIs. In fact, in 2023 the WHO released its first-ever research-based agenda on hand hygiene in healthcare settings. Working with experts from around the world over the space of two years, WHO were able to identify over 150 research priorities in the realm of hand hygiene, including the impact of hand hygiene on HAIs. The report also found that most infections that are acquired in a healthcare setting can be completely prevented or avoided if basic hand
Despite the clear benefits of hand hygiene, healthcare facilities often face challenges in ensuring consistent compliance among staff. Various factors contribute to suboptimal hand hygiene practices, including time constraints, inadequate resources, and lack of awareness. Additionally, cultural, and behavioural barriers may hinder adherence to protocols, as some healthcare workers may underestimate the importance of hand hygiene or perceive it as inconvenient. Addressing these challenges requires a multifaceted approach that addresses both individual behaviours and systematic issues within healthcare organisations. It is no secret that healthcare workers are overworked and healthcare facilities are underfunded. “The sheer number of times that hand cleaning is needed is a challenge. Sometimes a healthcare worker may clean their hands up to a hundred times during a shift. Slowing down and taking time to clean one’s hands, during a busy work shift is a challenge,” Glowicz adds. To improve hand hygiene practices, hospitals must implement comprehensive hand hygiene programmes that address the root causes of non-compliance. Key components of effective programmes include leadership commitment, education and training, access to hand hygiene products, monitoring and feedback mechanisms, and integration of technology for enhanced compliance.
“All the supplies needed to clean the hands of healthcare workers need to be available within their workflow. Having hand sanitiser dispensers at the entry to a room and inside the room can help them have quick and easy access to supplies right where they are needed,” advises Glowicz.
While implementation of sanitising stations seems like an easy solution, a 2023 article published in the Journal of Current Infection Disease Reports, ‘Healthcare Personnel Hand Hygiene Compliance: Are We There Yet?’, found that these stations are frequently empty, broken, hard to find, or obstructed. Analysis of qualitative data on barriers to hand hygiene also found that in instances where there are barriers, such as sanitisers being broken or empty, healthcare practitioners often do not go out of their way to seek out functioning stations. Strong leadership is essential for setting expectations, fostering a culture of safety, and
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