Hand-hygiene compliance drops at the end of shifts

Hospital workers are less likely to wash their hands toward the end of their shifts, according to new research that suggests the lack of compliance is due to fatigue from the demands of the job.

Researchers, led by Hengchen Dai, a Ph.D. candidate at the University of Pennsylvania, analyzed three years of hand-washing data from more than 4,000 caregivers in 35 hospitals across the U.S. Most of the caregivers were nurses (65 percent) and the others were patient care technicians, therapists or physicians.

They discovered hand-washing compliance rates dropped an average of 8.7 percentage points from the beginning to the end of a typical 12-hour shift, according to the study, published by the American Psychological Association.

Increased work intensity was also associated with the drop in compliance. But more time off between shifts restored workers' executive resources as they followed hand-washing protocol more carefully after the long breaks, researchers said.

"Demanding jobs have the potential to energize employees, but the pressure may make them focus more on maintaining performance on their primary tasks (e.g., patient assessment, medication distribution), particularly when they are fatigued," Dai said in an announcement about the study findings. "For hospital caregivers, hand-washing may be viewed as a lower-priority task and thus it appears compliance with hand-hygiene guidelines suffers as the workday progresses."

The findings suggest that that a demanding work environment can produce negative consequences far more rapidly than prior work exploring the effects of high job demands has recognized, the authors concluded. "Clearly, future research should investigate how to reduce these harmful effects of work demands on routine compliance," they said.

The study is among many this year that explored hand-hygiene compliance within the healthcare industry. For example, a July study in the American Journal of Infection Control supported previous research that fist-bumps are a more hygienic alternative to handshakes or high-fives in a healthcare setting. In October, the American Society of Anesthesiologists published research that showed providing healthcare workers with their own hand-sanitizing gel increased hand-hygiene compliance significantly.

To learn more:
- read the study (.pdf)
- here's the announcement

Suggested Articles

According to a new report, 79% of facilities scored less than a C in terms of conformance with national cybersecurity standards.

There's a perfect storm brewing in behavioral health right now. There are opportunities opening up for innovators to help improve access to care.

Telehealth company Amwell saw its stock spike 42% in its first day of trading Thursday after raising an outsized initial public offering.