hand hygiene
hand hygiene
By Robert P. Lee
What You Should Know Before Hospital Admission
At the Infection Prevention Exchange( IPEX), we are assessing the critical but often overlooked factor in a patient’ s journey to recovery, the patient’ s hospital room. Infection prevention is a series of strategic actions applied synchronously to prevent hospital acquired infections. This layered, systems-based approach is a horizontal rather than the more traditional vertical or single-intervention method.¹
Unfortunately, our healthcare system is often reliant on pharmaceuticals as its frontline defense against infection. While important, this mindset can downplay critical non-pharmacological interventions that rely on science, structure, and consistent execution to prevent pathogen transmission and potential infection.
The Hidden Risks in Hospital Rooms
Let’ s consider this issue in more depth. Hospital rooms are not only a focus of recovery from surgery and illness but also potential locations for pathogen transmission. Fomites are essential to pathogen movement from one patient to another, one environmental site to another or from environmental surfaces to the patient, whether equipment, objects, hands and / or surfaces. From ceiling to floor, a patient room can act as a reservoir for harmful microorganisms. The room may look clean or smell clean, but true decontamination is far more complex.
A recent genomic study that tracked Clostridioides difficile( C. diff) transmission in ICU settings concluded:“ These results challenge the idea that nosocomial transmission is not a primary source of acquisition and underscore the importance of hand hygiene and environmental decontamination … understanding the transmission pathways of C. difficile within healthcare facilities, particularly the roles of environmental surfaces and healthcare personnel hands, is critical to improving infection control measures.”²
Why Design and Workflow Matter
Take a look inside any single-occupancy hospital room with a bed, sink, bathroom, chairs, workstations, and a hodgepodge of medical equipment, usually arranged with no standard workflow in mind. This randomness extends to safety practices such as hand hygiene, which remains one of the most effective yet underutilized interventions to prevent the spread of infection.
Without a standardized layout and process, staff and patient interactions become unpredictable and this chaos engenders poor hand hygiene compliance, putting both patients and healthcare workers at unnecessary risk. Consider these questions:
• Can hospital rooms be designed for greater safety and efficiency?
• Can we reduce hand hygiene burden while improving compliance and outcomes?
• Can this be done cost-effectively?
Let’ s consider the hospital room of the future, designed for better outcomes:
Standardize Workflow
• Analyze room layout and flow per unit using Lean Six Sigma and value stream mapping.
With the rise utilization of genomics and real-time data, the link between environmental cleanliness and infection risk is becoming scientifically validated. By redesigning patient rooms with considering safety, efficiency, and standardization in mind, we can significantly enhance infection prevention for protect patients and healthcare workers alike.”
• Align workflows with best safety practices.
• Standardization is equated with consistent cleaning protocols and fewer“ missed” spots.
Create Protection Zones
• Establish designated zones for furniture, equipment, and staff-patient interaction.
• Implement a“ patient protection zone” to track and monitor hand hygiene more effectively.
Introduce a Safe Zone( No Hand Hygiene Required)
• Use visual cues( e. g., red tape at the doorway) to define entry zones where hand hygiene is not mandatory unless there is patient or critical environmental contact occurs.
• This approach, already used in ORs, could reduce hand hygiene events by up to 50 percent.
Audit & Optimize Hand Sanitizer Placement
• Add dispensers near at critical locations: both sides and foot of the bed, workstations, and equipment areas.
• Consult fire safety guidelines for placement approval.
Invest in Training and Simulation
• Use simulation centers( or create your own on-site) to train staff on standardized workflows and safety protocols.
• Track compliance and provide real-time feedback using scoreboards or dashboards.
With the rise utilization of genomics and real-time data, the link between environmental cleanliness and infection risk is becoming scientifically validated. By redesigning patient rooms with considering safety, efficiency, and standardization in mind, we can significantly enhance infection prevention for protect patients and healthcare workers alike.
Want to lift morale? Let your team know how these changes could cut decrease hand hygiene requirements by 50 percent while concurrently improving improve safety.
Robert P. Lee, BA, is CEO and founder of MD-Medical Data Quality & Safety Advisors, LLC, home of THE IPEX – The Infection Prevention Exchange, a digital collaboration using data, tech, and AI to reduce the risk of healthcare-associated infections( HAIs).
References:
1. Septimus E, et al.( 2014). Approaches for Preventing Healthcare-Associated Infections. Infection Control and Hospital Epidemiology, 35( 7), 797 – 801.
2. Keegan LT, et al.( 2025). Environmental and HCP Sampling & Unobserved C. diff Transmission in ICU. JAMA Network Open, 8( 4): e252787.
may-june 2025 • www. healthcarehygienemagazine. com •
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