How hospitals can reduce infections, increase hand-hygiene compliance

Two new studies shed new light on what hospitals can do to cut down on infections and improve hand hygiene.

Ascension Health, the nation's largest not-for-profit health system, surveyed 71 of its member hospitals on their infection control procedures for catheter-associated urinary tract infections, central line-associated bloodstream infections, ventilator-associated pneumonia and surgical-site infections. The survey found that while the majority of hospitals had infection prevention policies in place relating to hand hygiene, devices, multidrug-resistant organisms and surgery, only about 40 percent had policies for antimicrobial stewardship.

Policies on devices also varied depending on the hospital. Use of bladder scanners to analyze urinary retention was more common at larger and mid-sized hospitals than smaller ones, according to the survey. Over 75 percent of hospitals placed determining the need for a urinary catheter primarily in the hands of nurses, but only 26.8 percent of nurses and 11.3 percent of patient care technicians received annual training on catheter placement and maintenance.

Meanwhile, a study conducted at 719-bed Rhode Island Hospital monitored staff on more than 160,000 occasions to determine how often they cleaned their hands between July 2008 and December 2012. Over the course of the study, hand hygiene improved from 60 percent to 89 percent. Compliance was greater when healthcare workers were leaving rooms, working the evening shift, and exiting or entering the rooms of patients known to be infected with antibiotic-resistant bacteria, according to the research.

"Hand hygiene is the most important intervention to reduce the risk of hospital-associated infections, but many hospitals have struggled to develop a culture of safety where high hand-hygiene compliance becomes the norm rather than the exception," principal investigator Leonard Mermel, medical director of the department of epidemiology and infection control at Rhode Island Hospital, said in a statement.

A study earlier this month found that keeping hospital hand sanitizer dispensers clean and giving healthcare workers personal hand gel can spur noticeable decreases in bacterial contamination, FierceHealthcare previously reported.

To learn more:
- here's the the RI Hospital study (preview only)
- read the statement
- check out the Ascension survey abstract