Hospitals are finally turning up the heat on hand hygiene.The problems is new anti-biotic resistant bacteria, such as deadly MRSA (methycellin resistant stapholoccus aurus) combined with shockingly low hand washing rates by doctors and other health care workers.
With rising alarm over hospital infections, which cause 90,000 deaths annually, a growing number of hospitals are adopting aggressive hand-hygiene surveillance and monitoring programs, and in some cases imposing penalties for doctors, nurses, and other health-care workers who don't follow the rules.
In an effort to be launched this week, the Centers for Disease Control and Prevention is collaborating with the nonprofit Institute for Healthcare Improvement and two leading infection-control professional societies in a program to boost compliance using behavior-modification techniques, "best practice" guidelines, and rigorous programs to monitor adherence.
IHI focuses on ways to "remove barriers that exist in the health-care system," although some hospitals in Kentucky rely on more harsh methods to "encourage" compliance:
The hospitals began a program to identify offenders, requiring them to undergo hand-hygiene tutorials and education, and then escalating the severity of penalties for noncompliance -- including disciplinary action or dismissal for repeated violations.One hopes the doctors are being disciplined as much as the other personnel.
Those who read the entire article will find some clues about why compliance is so low (aside from those lazy workers, of course), and some hints about how to improve it:
Hospitals also have to be vigilant about maintaining alcohol-rub dispensers, which often don't work, aren't refilled, or aren't placed conveniently, the group says.In other words, compliance with safety procedures is generally more successful when empoyees are involved -- and not just hospital hygiene, that goes for any safety program.
Hospitals also can enlist staffers in making hand-hygiene rules easier to follow, says Charles Huskins, an author of the IHI tool kit for hand hygiene and an infectious-disease expert at the Mayo Clinic in Rochester, Minn. Compliance rates at Mayo hospitals were sharply improved, in part, because employees were allowed to test different alcohol hand rubs, and chose one with strong moisturizers to avoid irritation that might lead to discontinued use. "That made a really big difference in a chilly northern climate in winter," Dr. Huskins says.