Hospital perceptions of hand hygiene clash with reality

Hospitals and their medical staff have different ideas of how well the facility meets hand-hygiene guidelines, according to a new survey of infection preventionists, nurses and other healthcare professionals.

Two-thirds of the 400 respondents said their facility reports hand-hygiene compliance rates of at least 81 percent, but 59 percent estimated true compliance is probably less than 70 percent, according to the survey by Charlotte, North Carolina-based DebMed.

The survey also found that less than half (44 percent) of respondents follow Centers for Disease Control and Prevention and World Health Organization guidelines for hand hygiene, which go beyond just cleaning hands when entering and exiting patient rooms. One-third of respondents said their hospital plans to purchase an electronic hand-hygiene monitoring system in the next year, according to an announcement describing the findings.

"While there are gaps in the measurement and reporting of hand-hygiene compliance throughout hospitals, and facilities face stretched budgets and priorities, there is a clear increase in awareness of and commitment to better practices," DebMed spokeswoman Heather McLarney said in the announcement. The company sells hand-hygiene products and monitoring systems.

While somewhat disconcerting, the findings are less alarming than preliminary results of a study by Robert Wood Johnson University Hospital that only 13 percent of 1,500 emergency medical providers surveyed washed their hands before touching patients.

Some hospitals report significant success in raising hand-hygiene compliance. A campaign at MetroHealth Medical Center in Cleveland, for example, increased hand-washing compliance to 97.6 percent and cut hospital-acquired infections by 38 percent. Cases of ventilator-associated pneumonia tumbled by 71 percent in the four-year period.

And a study published last month in Infection Control & Hospital Epidemiology found that using an automated hand-hygiene monitoring system improved adherence in a large intensive care unit from 20.85 percent to 27.9 percent. The reason? Peer pressure; staff knew they were being watched during the 10-day study period.

For more information:
- here's the survey announcement