Becker's Clinical Quality & Infection Control

22 HAND HYGIENE Nurses Face Far More Hand Hygiene Opportunities Than Physicians, Study Finds By Shannon Barnet D oes how frequently a clinician needs to wash his hands affect hand hygiene compliance rates? A study published in the American Journal of Infection Control examined the connection between hand hygiene burden and compliance among nurses and physicians. The researchers used four trained auditors to measure the daily number of hand hygiene opportunities by shift for nurses and physicians in two wards of an 850-bed university teaching hospital. The auditors collected data for 24 hours over seven days. All total, they recorded 21,000 hand hygiene opportunities in the medical and surgical wards. The study revealed nurses had an average burden of 55 hand hygiene opportunities per 24 hours, or 27 hand hygiene opportunities per shift. This is roughly three times higher than the burden experienced by physi- cians, who had 16 hand hygiene opportunities per 24 hours, or eight hand hygiene opportunities per shift. Despite facing a higher burden of hand hygiene oppor- tunities, the average nurse compliance rate (76 percent) for the week was approximately 1.5 times higher than compliance rate for physicians (52 percent). Ultimately, the authors of the study concluded the low hand hygiene compliance rates among physicians can- not be explained by having fewer opportunities to be compliant with hand hygiene protocol. n Patients Transfer MDROs to Post-Acute Facilities Via Their Hands By Shannon Barnet T he importance of hand hygiene compliance has been drilled into many healthcare workers, but a study released in March suggests seniors being transferred from a hospital to a post-acute care facility may require further education on the infection prevention measure. Researchers from the University of Michigan Health System in Ann Arbor discovered one in four seniors bring stow- aways — multidrug-resistant organisms — on their hands from hospitals to PAC facilities. Additionally, seniors who transfer to nursing homes continue to acquire new super- bugs during their stay. All total, the study included 357 seniors admitted from a hospital to one of several PAC facilities in southeast Michigan. "We've been educating healthcare workers for decades about hand hygiene, and these numbers show it's time to include patients in their own hand hygiene performance and education," said lead author Lona Mody, MD, the associate chief for clinical and translational research at the U-M Geriatrics Center and a research scientist at the Ann Arbor VA Geriatrics Research Education and Clinical Center. The findings were published in a JAMA Internal Medi- cine research letter in March. n Good Hand Hygiene Key in Slowing Down Antibiotic Resistance By Brian Zimmerman P oor hand-washing is among the factors contributing to the proliferation of an- tibiotic-resistant infections, according to a recent report issued by the Review on Antimicrobial Resistance. e RAR is a British effort aimed at examin- ing possibilities to stifle the tide of antibiotic resistance, according to National Geographic. Its previous reports have been focused on topics like drug development and vaccine research. Recently, however, the RAR shied tone by issuing a report focused on sanita- tion and hospital hygiene. In this recent report, the RAR found that only 30 to 40 percent of hospital staff wash their hands as oen as they should, with physicians performing worse than the nurs- ing staff. While consistent hand-washing as infection prevention is not a new concept, it is under-practiced. "We felt it would be of value to point out that just doing the basics can make a huge amount of difference," Jim O'Neill, the former chief economist for Goldman Sachs and chair of the RAR, told National Geo- graphic. "It is concerning that not enough has happened, and that's a reason for a new, independent voice to highlight that." While it is important that hand-washing rates improve in hospitals, the RAR asserts there is a dearth of research into what actually motivates behavioral changes in healthcare workers. e group recommends funding studies to discern what measures should be taken to improve hand hygiene in hospitals. n

• Cover