hand hygiene
hand hygiene
By Robert P . Lee
Visitor Hand Hygiene Compliance and the Infection Prevention Chain
A common refrain pertinent to the infection prevention chain is that each segment is only as strong as the weakest link . Pathogens spread through the hospital ecosystem via carriers , most commonly hospital personnel and patients , and hands are the most common vector of transfer . A major component of the infection prevention chain is the education and training of staff and recently the investment in technology to sustain and improve hand hygiene compliance . However , another important potential link in the infection prevention chain is the transfer of pathogens by visitors , often given inadequate consideration .
In my anecdotal experience visiting hospitals , visitor hand hygiene is seldom , if ever , a consistent focus of infection prevention programs . Pitts , et al . noted that staff hand hygiene compliance is generally 25 percent to 40 percent , while visitor hand hygiene is usually less than 1 percent . A recent study by Kaya , et al ., noted , “ Of patient companions and visitors , 96.2 percent stated that they did not receive training on the importance of handwashing during their stay in the hospital .”
Several investigators have addressed some of the issues surrounding visitor hand hygiene and the challenges that factor into such low hand hygiene compliance . Hobbs , et al . noted the lack of placement of hand sanitizer dispensers where visitors commonly enter the hospital , typically the front door of the hospital . Further , hand sanitizing displays in the hospital entrance alone would help raise overall visitor hand hygiene awareness and knowledge of its importance and potentially increase visitor compliance . Visitors ( and often patients ) receive little , if any , education and training in hand hygiene , such as the why , how and when .
What might be some practical options to address some of these challenges ?
A common requirement for all visitors
Another important potential link in the infection prevention chain is the transfer of pathogens by visitors , often given inadequate consideration .”
entering the hospital patient-care area is to secure an identity badge as they pass through security . What if part of this process was to require new visitors to watch a brief one-minute video addressing the importance of hand hygiene ? Certainly , the COVID-19 pandemic raised the issue of the importance of prevention of pathogen transmission among members of the general public . Further , most visitors to the hospital are coming to see friends and family , and preventing infection could and should be an important aspect of such visits . It seems an unrealistic expectation of visitors to understand the importance of hand hygiene without providing appropriate information and the means to address the problem , as noted above .
They then can take this certification to security check-in and receive permission to enter the hospital . If the hospital is a subscriber to hand hygiene technology , visitors could at that time receive a hand hygiene compliance ID badge . This badge will remind them when to sanitize their hands . Additionally , it will provide tracking information and contact tracing should these features be necessary .
This process is a start , an opportunity to address one weakness in the chain of infection prevention , seldom currently a high priority at most hospitals . It is an opportunity to provide visitors with the knowledge of the importance of hand hygiene in infection prevention and hopefully also offer easy access to hand hygiene before visitation . If current visitor compliance is truly less than 1 percent , there is really only one way to go .
Robert Lee , BA , the CEO and founder of MD-Medical Data Quality & Safety Advisors , LLC , is the senior biologist and performance improvement consultant . MD-MDQSA is the home of The IPEX - The Infection Prevention Exchange , a digital collaboration between selected evidence-based solutions that use big data , technology , and AI to reduce risk of HAIs . www . healthcarehygienemagazine . com • august 2023
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