New push for clean hands in hospitals

Infection-control experts say that with hand hygiene compliance at less than 50%, it's time to start washing up.

By Damon Adams, AMNews staff. May 8, 2006.

Physicians may know that they need to scrub their hands for at least 15 seconds with soap or an alcohol-based rub. But apparently many still are not practicing what's being preached.

That's why the Institute for Healthcare Improvement, Centers for Disease Control and Prevention and two other organizations collaborated on a new how-to guide to improve hand hygiene among physicians and other health care workers.

They say compliance of hand hygiene recommendations at hospitals remains unacceptable -- less than 50% -- and changes are needed to cut health care-associated infections.

The guide's recommendations are pretty basic: conducting demonstrations of correct hand-washing techniques, monitoring how well physicians and others comply, and encouraging patients to remind doctors to clean their hands.

"This isn't magic. Like anything else, it's discipline," said Don Goldmann, MD, senior vice president of IHI and professor of pediatrics at Harvard Medical School, Boston.

Hospital infections affect 2 million patients and cause about 80,000 deaths annually, the guide stated. Hand hygiene is considered a top infection-control measure. But poor compliance continues, and experts say these are reasons why: lack of knowledge about the importance of hand hygiene in reducing the spread of infection; poor access to hand-washing facilities; and little institutional commitment to hand hygiene.

Organizations have tried to inform health professionals about keeping hands clean. In 2002, the CDC published guidelines on hand hygiene in health care settings, noting that alcohol-based hand rubs were preferred in most situations. In 2005, the World Health Organization issued guidelines that stressed multidimensional strategies as the best approach. Meanwhile, the American Medical Association said the CDC and other groups should promote the Association's four principles of hand awareness to the public to help prevent the spread of infectious disease.