Peer pressure may improve hand-hygiene compliance

In high school we're told not to give in to peer pressure. But it might be the key to boosting hand-hygiene compliance in hospitals, according to a new study published in Infection Control & Hospital Epidemiology.

Researchers from the University of Iowa's Carver College of Medicine used an automated hand-hygiene monitoring system to observe staff in a 20-bed medical center intensive care unit at a large university hospital, according to the study. The technology detected whether healthcare workers washed their hands before coming into a patient's room and estimated the location of other healthcare workers with respect to the workers coming into or out of a room.

Over a 10-day period, researchers identified 47,694 hand-hygiene opportunities. When a healthcare worker was alone, the observed adherence rate was 20.85 percent. But when other healthcare workers were nearby, the adherence rate was 27.9 percent, according to the study. However, compliance may be higher because the number recorded by the automated system did not count dispensing events inside the patient's room.

Researchers also found adherence increased with the number of nearby healthcare workers, leading them to conclude that presence and proximity of other healthcare workers was associated with higher hand-hygiene rates. Overall, adherence was slightly higher at night and higher among nurses than doctors.

"Our results speak to the importance of the social environment in healthcare," the authors write, and "may have implications for disease modeling, a field that is increasingly stressing the importance of human behavior on the spread of diseases."

Some hospitals take a proactive approach to hand-hygiene compliance. For example, MetroHealth Medical Center in Cleveland hired four hand-washing monitors, who observed and tracked who washed their hands as they walked in and out of patient rooms, FierceHealthcare previously reported. After this initiative, central line-associated bloodstream infections dropped 35 percent, ventilator-associated pneumonia fell 71 percent, and surgical site infections decreased by 64 percent, while hospital-acquired infections at the hospital as a whole fell 38 percent.

To learn more:
- here's the study