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The ability of patients to participate in patient empowerment initiatives may be limited due to factors such as illness , cognitive impairment , and low health literacy .” — Curtis J .
Donskey , MD
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Although the patients surveyed by Knighton , et al . ( 2020 ) previously had no difficulty seeing to their hand hygiene prior to hospitalization , more than one-half of the survey participants reported , mostly or completely agreeing that the hand hygiene of the healthcare staff was more important than their own . Close to one-half of the participants reported not being satisfied at all with their ability to maintain their hand hygiene in the hospital , whereas less than 10 percent of patients were very satisfied with their ability to maintain hand hygiene .
While partnering with patients in their care is recommended , there is great variation of health literacy in the patient population , thus necessitating including patients ’ family members in the dialogue about HAI prevention . Inclusion of family members should be considered because they often play a major role in healthcare decision-making .
“ The ability of patients to participate in patient empowerment initiatives may be limited due to factors such as illness , cognitive impairment , and low health literacy ,” says internist Curtis J . Donskey ,
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MD , of the Geriatric Research , Education and Clinical Center at the Louis Stokes Cleveland VA Medical Center . “ Therefore , engaging family members participating in care of the patients is recommended .”
A recent review by Donskey ( 2023 ) highlights some of the areas where patient empowerment initiatives in infection control and antimicrobial stewardship may be useful and reports on available evidence that such initiatives can be beneficial .
Patient hand hygiene is one of the key interventions cited by Donskey , who explains , “ Patients colonized or infected with healthcare-associated pathogens frequently have hand contamination and can transfer pathogens to surfaces or to hands of providers . In recent studies , approximately half of patients with methicillin-resistant Staphylococcus aureus ( MRSA ) colonization or Clostridioides difficile infection ( CDI ) had positive hand cultures with the colonizing or infecting organism ; hand hygiene with alcohol hand sanitizer and handwashing with soap and water were effective in reducing contamination with
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MRSA and C . difficile , respectively . For patients not colonized with pathogens , patient hand hygiene might potentially reduce the likelihood that pathogens acquired on hands will establish colonization or contaminate devices or wounds .”
Donskey says it is critical for healthcare personnel to realize that patients often lack access to hand hygiene products or have access to products that are difficult to use . For example , some studies have indicated that moist towelette packets provided with meal trays may be hard for elderly or debilitated patients to open . Therefore , ensuring that alternate forms of hand hygiene – such as pump-bottle hand hygiene dispensers -- are available to patients can help them break this barrier . For example , in separate studies conducted in a Veterans Administration ( VA ) hospital , patients were provided with a bottle of hand sanitizer and were educated about four or five moments when patient hand hygiene is recommended ( Sunkesula , et al ., 2015 ; and Rai , et al . 2015 ). The four moments for patient hand hygiene include before and after touching wounds /
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