The Dirty Truth About Clean Hands in Hospitals

Efforts to reduce infections in hospitals by getting workers to wash their hands more often got a boost recently, with the Joint Commission Center for Transforming Healthcare – part of the agency that accredits hospitals – announcing a new program in partnership with eight hospitals and health systems.

An article from Health Leaders Media about the effort quotes Joint Commission President Mark Chassin, MD, as saying the participants recognize “that simply posting more signs or demanding that healthcare workers try harder isn't enough.”

That is encouraging. But what I found more interesting, and perhaps more encouraging, is a recognition that data about hand-washing programs must be accurate – and often isn’t.

The center has already determined that many hospitals have been lulled by faulty data into thinking that hand washing is occurring more than is actually the case. In fact, using The Joint Commission-developed enhanced measuring standards, the eight hospitals in the study found that their caregivers washed their hands less than 50% of the time.

A fundamental principle of any improvement effort is that you must be able to accurately measure performance, both before and after implementing initiatives.

The article also mentions some of the initiatives that may be implemented.

To improve compliance, new strategies being tested include: Holding everyone accountable—doctors, nurses, food service staff, housekeepers, chaplains, technicians, and therapists; using a reliable method to measure performance; communicate frequently and use real time performance feedback; and tailor education in proper hand hygiene for specific disciplines.

This is one of a series of Joint Commission efforts. Future programs will target breakdowns in hand-off communications, improving infection control, mix-ups in patient identification, and medication errors.

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