Hand-washing by health care workers — or their failure to do so — has received repeated attention by the media. But the hand-washing compliance rate remains frustratingly low — as little as 30 percent of the time that health care workers interact with patients. That’s right; less than a third of the time they interact with patients, doctors and nurses fail to wash their hands. Hand-washing is the first line of defense against health care acquired infections. Hand-washing can save lives and prevent life-long disabilities due to infections.
A recent article in The New York Times details the lengths to which some hospitals are willing to go to ensure their employees are performing this simple yet life-saving task. As absurd as it sounds, one hospital monitors its employees via video. Workers in India then monitor the videos and report hand-washing compliance statistics back to the hospital. That’s a mind-boggling use of outsourced labor, but the real story is that hand-washing compliance is still unacceptably low, and this has to change.
Hospitals use different methods to try to raise hand-washing compliance of health care workers and doctors, who have the lowest compliance levels. The Greater New York Hospital Association, for example, trains some of its employees to be hand-washing “coaches,” who give out red cards or gold stars to other employees based on their hand-hygiene compliance. It sort of sounds like the rewards we remember from grade school, but if it works to increase hand-hygiene compliance it’s a win for patients.
Another incentive for hospitals to figure out ways to get workers to wash their hands comes in the form of payment incentives: The largest payer of health care, Medicare, no longer reimburses hospitals for treatment associated with certain infections acquired in a hospital. In the near future, the program will further cut payments to hospitals with the worst infection rates. We think that this is a good thing and hope to see even more action by hospitals to prevent infections on every floor in every ward.
It’s encouraging to see hospitals trying new things to improve hand-washing compliance, but it’s disappointing that this is still a problem and that patients continue to pay the price when doctors and health care workers fail to clean their hands.
So what can patients do? Speak up when you’re in the hospital and have an advocate with you – a friend or family member – who will speak up when you cannot. Ask your doctors and nurses to wash their hands in front of you before touching you, especially any surgical wounds or IV lines. It may throw them off for a second, but it also shows that you are aware of the dangers of hospital germs. The World Health Organization has identified “5 moments for hand hygiene.” Also, check out this Consumer Reports video on how to correctly wash your hands to avoid getting sick. For more info on hand hygiene in health care settings, visit the CDC website for educational tools and other basics.