Few People Know Handwashing Guidelines

A recent study published in the American Journal of Infection Control examined compliance with the World Health Organization’s (WHO) “My 5 Moments for Hand Hygiene” approach. Specifically, according to Becker’s Clinical Leadership and Infection Control reports, the study was conducted at a healthcare facility between July and August 2016 and compliance was found to be low.

In addition to using a modified WHO hand hygiene observation form, researchers used a 26-question survey to gather healthcare workers’ knowledge and opinions on hand hygiene. They found that workers performed proper hand hygiene only 35 percent of the time, and only 21 percent of workers were able to recall all five moments.

Understanding that handwashing compliance is a struggle, hospital environmental services managers endeavor to come up with new and better ways to engage healthcare workers in the battle against HAIs.
“The problem isn’t given enough attention or the right kind of attention. There may be guidelines about how and when to wash, but actual reliable verification is not going on,” said Jim Mann of the Handwashing Leadership Forum in Libertyville, Illinois. “People accept that it is a national problem, but they don’t see themselves as part of that problem. Workers know patients have the infections, but they don’t think they are causing it.”

Experts agree that hand hygiene improvement interventions must include audits of compliance with feedback, which are most often done by direct observation. Unfortunately, observation is expensive, subjective and requires careful training. Observation can also be prone to bias, which means that the compliance rates probably aren’t accurate.

“Reports might say compliance is 90 percent, but if we go in and observe, we find that it’s really closer to 30 percent,” said Mann.