Starting With Hand Hygiene Practices Facilities in New Hand Hygiene Project See Compliance Increase From 48% to 81%
U.S. healthcare facilities are grossly underperformingin hand hygiene compliance, which could impact healthcare-associated infections and patient safety,said two of the world's foremost experts on infection prevention and hand hygiene.
Speaking last week before more than 200 healthcare leaders at a hand hygiene forum organized byLoyola University Medical Center and Medline Industries, Inc., at Loyola's Strich School of Medicine inMaywood, Ill., Professor Didier Pittet, MD, director of the infection control program at the University ofGeneva, Switzerland, and Mark R. Chassin, MD, FACP, MPP, MPH, president of The Joint Commission,cited time constraints, product misconceptions and faulty data as main reasons for the country's poorhand hygiene compliance, but also offered hope for improvement.
The Joint Commission Center for Transforming Healthcare tackled the issue of hand hygiene compliance as its first project, according to Dr. Chassin. The participating organizations were surprised to learn that their rate of hand hygienecompliance averaged 48 percent.
"These healthcare organizations had the courage to step forward to tackle the problem of hand washingby digging deep to find out where the breakdowns were taking place so we could create targetedsolutions," Dr. Chassin said. "We are very optimistic since the original facilities participating in theproject have seen their average compliance increase to 81 percent and have sustained that level for 10months."
Time Constraints for Hand Hygiene
Other reasons for poor compliance, according to Dr. Pittet, is lack of time by healthcare workers toperform hand hygiene and misinformation on what type of product is most effective -- soap and water,alcohol-based hand sanitizers or foams.
"The problem with soap and water is that it takes anywhere from one to one-and-a-half minutes toperform proper hand hygiene. If workers wash their hands 15-20 times in an hour, that would takeabout half an hour, which is totally unrealistic. Also, after several washings, your hands will become dryand chapped," said Dr. Pittet. "Alcohol-based hand rubs take only 15-30 seconds, they're also moreeffective than soap and water, better for your hands and more convenient because you can carry themaround with you."
Need for higher percentage alcohol to increase effectiveness
Dr. Pittet, a member of the Advisory Board of the World Health Organization (WHO) World Alliance forPatient Safety, also emphasized that there is no evidence in the current published literature thatsupports the effectiveness for foam-based <a href="http://www.reddingmedical.com/merchant.cfm?id=90&step=2&parent=674">hand hygiene consumer medical products</a>. However, he strongly suggests usingalcohol-based hand rubs with at least 80 percent ethanol -- a significantly higher percentage than 62percent ethanol, commonly used by U.S. facilities, which is at the low end of the CDC recommendation.
"It's hard to believe that there have been so many products that have been used in the United Statesthat will never pass the European norms, So some of the products that you are using inthe United States have not made it to the European market, because they just don't meet the norms."
Center for Transforming Healthcare hand hygiene solutions now available
According to Dr. Chassin, the solutions developed by the original organizations participating in theCenter for Transforming Healthcare's hand hygiene project are now available via the Center's TargetedSolutions Tool™ (TST), a complimentary data-driven application. The solutions are validated andcustomized to address an organization's particular barriers to excellent performance. Use of the tool isself-paced, confidential, and offers instantaneous data analysis.
Dr. Chassin said the good news is that more healthcare facilities are focusing major efforts on handhygiene compliance. He cited that more than 1,500 projects at 900 organizations are now using theCenter for Transforming Healthcare's hand hygiene TST.
About the Joint Commission Center for Transforming Healthcare
Established in 2009, the Joint Commission Center for Transforming Healthcare aims to transformAmerican healthcare into a high-reliability industry that ensures patients receive the safest, highestquality care they expect and deserve. The Center's participants -- the nation's leading hospitals andhealth systems -- use a proven, systematic approach to analyze specific breakdowns in care anddiscover their underlying causes to develop targeted solutions for healthcare's most critical safety andquality problems. The Center is a not-for-profit affiliate of The Joint Commission, which shares theCenter's proven effective solutions with its more than 18,000 accredited healthcare organizations. Learnmore about the Center at <a href="http://www.centerfortransforminghealthcare.org/">centerfortransforminghealthcare.org</a>