Best tricks for better hand-hygiene compliance: A watchful eye and the yuck factor

Healthcare worker in white lab coat and surgical scrubs washes his hands in sink

The secrets to get healthcare workers to properly wash their hands may be standing over them or “grossing them out” and showing them magnified images of what their unwashed hands actually look like under a microscope, according to two new studies being presented next week at the Association for Professionals in Infection Control and Epidemiology’s annual conference.

The “yuck” factor seemed to do the trick for healthcare workers at Henry Ford Hospital in Detroit. Compliance rates improved on average by nearly 24 percent when healthcare workers were shown magnified images of bacteria found on mousepads, work stations and their hands, researchers said.

Healthcare workers in four patient care units did a better job cleaning their hands after they saw the images, which “grossed” them out, researchers said.

“These images put a face to the continuous hand-hygiene education that healthcare workers get,” said Ashley Gregory, an infection prevention and control specialist at Henry Ford. “They stick in your mind.”

“I think healthcare workers in general become numb to the fact that hospitals are an environment of germs,” Gregory said in the study announcement. “We believe our study demonstrates that pictures go a long way to breaking that detachment, and gives hospitals a new tool for their hand-hygiene toolkit.”

A watchful eye may also help boost hand-hygiene compliance, according to researchers at Santa Clara Valley Medical Center in San Jose, California, according to an ABC News report. The study found that doctors may change their behavior when they know they are being watched, a phenomenon known as the Hawthorne Effect.”

The study had two types of auditors assess hand hygiene: infection prevention nurses, who all clinicians at the hospital recognized as the “hygiene patrol" and high school and college student volunteers, who hospital staff did not consistently recognize, according to the article. The nurses noted much higher compliance rates, a fact that researchers attributed to the “Hawthorne Effect.”

“When we would come on the floor, I would notice that the nurses or providers were not using the alcohol,” Lisa Hansford, one of the infection prevention nurses, told ABC News. “Then they would glance up and see me and bend over backwards to lather up.”

- read the Henry Ford announcement
- here’s the ABC News article  

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