Hygiene Program Encourages Docs, Nurses to Scrub Up

NEW YORK (Reuters Health) - A program that publicizes the importance of hand washing and places alcohol hand rubs by each patient's bedside significantly boosts healthcare workers' compliance with hand washing guidelines, according to new study findings.

Specifically, after six weeks of participation in the program, nurses, doctors, physiotherapists and others with direct contact with patients improved their compliance from 51 percent to 83 percent.

However, doctors were least likely to wash their hands as often as recommended and showed the least improvement after the program, increasing compliance from 31 percent to 55 percent.

"If healthcare workers do not wash their hands between patient contact, then they carry pathogenic micro-organisms from one patient to another - i.e., they spread the infection," study author Sile A. Creedon of the University College, Cork, Ireland told Reuters Health.

"Therefore, a program such as this which increases healthcare workers hand hygiene practices logically reduces the risk of infection acquisition and resultant ill effects," Creedon noted. "In my opinion, this program is worth the time and money."

A significant percentage of hospitalized patients -- up to 15 percent, according to one study -- acquire infections in the hospital.

However, research shows that the rate of infection can fall by up to one third if hospital workers follow hygiene guidelines recommended by the U.S. Centers for Disease Control and Prevention.

Still, workers appear to only follow those guidelines about 50 percent of the time, citing a lack of equipment and time, as well as skin irritation from frequent washing.

During the intervention, healthcare workers received information about the importance of hand washing, and researchers placed alcohol rubs at each patient's bedside, which are less harsh on the skin.

Creedon observed 314 workers' hand washing behavior, and asked 62 workers to complete a questionnaire about how often they washed their hands, and their attitudes towards the practice.

After the intervention, healthcare workers were more likely to wash their hands when going from patient to patient, and after touching objects that may have been contaminated.

Workers also appeared to learn more about when to wash their hands, and reported that their skin condition improved from using the alcohol rubs.

"Another major finding was that healthcare workers are very busy and time is crucial," Creedon noted. "If hand washing is not facilitated in a convenient, time saving fashion, then it is difficult to envisage an increase in practices."

SOURCE: Journal of Advanced Nursing, August 2005.