Becker's Clinical Quality & Infection Control

7 Hand Hygiene Decision-Making, Lack of Knowledge Tank Hand Hygiene Compliance By Ellie Rizzo Study: Hot Water unnecessary for Handwashing By Ellie Rizzo W hile many believe hot water is more effective than cool water when it comes to handwashing, the temperature of the water used is not related to how well pathogens are eliminated during the process, according to research in the Journal of Consumer Studies. Researchers examined cleanliness of subjects' hands after washing in several different temperatures of water. While 70 percent of the test subjects be- lieved hot water was more effective than cold water for hand hygiene, water as cold as 40 degrees Fahrenheit reduced bacteria on hands just as well as warmer water, according to a report on the study from National Geographic. What's more, "warmer water can irritate the skin and affect the protective layer on the outside, which can cause it to be less resistant to bacteria," ac- cording to one of the study's authors. Skin irritation is one reason healthcare workers forgo hand hygiene, according to research published in late 2013. The energy expended as a result of using unnecessarily warm water for hand washing is approximately equal to the annual carbon emissions of Barbados, according to the National Geographic report. Researchers recommended using water at a "comfortable" temperature to wash hands, rather than using hot water. n 20% of u.S. Hospitals Missing Critical Hand Hygiene Station By Ellie Rizzo O ne in five U.S. healthcare facilities is missing alcohol-based hand sanitizer at some points of care, according to a study from the Columbia University School of Nursing in New York City and the World Health Organization, published in the American Journal of In- fection Control. Researchers surveyed 168 facilities across the country and found only 77.5 percent had alcohol-based sanitizer continuously available at all points of care. The problem also appeared to extend to leadership, with 10 percent of fa- cilities reporting senior leaders had not made an explicit commitment to hand hygiene. In addition, only about 50 percent of healthcare facilities, including hospitals, ambulatory care facilities and long-term care facilities had appropriated funds for hand hygiene training, according to a news release. Hospitals with higher staffing levels of infection preventionists had better hand hygiene policies and practices, according to the journal article. n T o understand reasons for hand hygiene noncompliance, just ask noncompliant healthcare workers. This is the approach researchers took in a study whose results have been published in the American Journal of Infec- tion Control. Researchers observed healthcare workers during their daily routines and collected real-time expla- nations of noncompliance directly after a health- care worker missed a hand hygiene opportunity. Responses were then sorted according to the The- ory Domains Framework, a heuristic to organize components of behavior change research. Of the 207 explanations for skipped hand hy- giene, 69 percent were attributable to reasons of memory, attention or decision-making and knowledge. Of the memory/attention/decision- making category (44 percent), healthcare workers cited memory, loss of concentration and distrac- tion by interruptions as factors contributing to noncompliance. Of the knowledge category (25 percent), healthcare workers citied lack of knowl- edge of specific hand hygiene indications. Of the 10 remaining domains, none accounted for more than 9 percent of the remaining expla- nations. The researchers concluded hand hygiene compli- ance could benefit from interventions targeted toward automatic associative learning and con- scious decision-making. Ensuring healthcare workers are properly educated on when hand- washing is appropriate is also key, they said. n Researchers surveyed 168 facilities across the country and found only 77.5 percent had alcohol-based sanitizer continuously available at all points of care. www.beckersinfectioncontrol.com or call (800) 417-2035 SIGN uP TODAY! Infection Control & Clinical Quality Becker's infection Control & Clinical Quality E-Weekly

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