How to do it ... Handwashing compliance

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Simple handwashing is indisputably the easiest, most effective way of preventing the spread of germs and infections anywhere, including healthcare settings. Yet it is far from being a widespread practice. Here are some strategies that could help change that.

1. It never hurts to remind staff — from administrators and frontliners to residents and visitors — of the risks.

“It has been suggested that 62% of men and 40% of women do not wash their hands after using the toilet,” says Therese Laub, LPN, CWS, wound care/product specialist at Gentell. “This is a problem. Especially in the patient care setting.”

Administrators need only know this, says Tom Bergin, healthcare marketing director for SCA's Away from Home Professional Hygiene business in North America: “In today's healthcare environment one of the biggest contributors to slipping bottom lines are healthcare-acquired infections, as they are extremely expensive for facilities due to readmissions, length of stay, and other direct and indirect costs, as well as reducing Medicare reimbursements.”

2. Aim to be both persistent and inclusive. 

Residents and their loved ones can be powerful allies if they can be convinced to handwash. The same goes for every facility employee they interact with, according to Gina Pugliese, RN, MS, FSHEA, vice president emeritus of the Premier Safety Institute.®

Bergin adds that prominent signage about your commitment to regular handwashing could improve the public perception of your facility. 

Laub suggests facilities host a regular “Coffee Clutch” or “Tea Time” with family and visitors to drive home the importance of hand hygiene.

3. Monitoring and messaging are critical.

Providers will better know their compliance rate, as well as barriers, after they establish a regular monitoring program your staff is aware of, advises Pugliese. Lisa Logan, RD, CNSC, enteral program manager/nutrition support clinician for McKesson Medical, even suggests cameras or electronic surveillance to monitor handwashing before and after resident contact. But remember: A carrot is better than a stick. 

“Have staff meet regularly, not to reprimand but to get them to work together to achieve better compliance with a goal to prevent infections in patients and themselves,” Pugliese says.

Have staff wear buttons that read, “Ask me if I washed my hands,” but be alert: While everyone urges facilities to make visual reminders like signage ubiquitous throughout, keep the messaging fresh. 

“Changing up hand hygiene communications on a regular basis keeps messages from wearing out with employees, ultimately helping hand hygiene protocol to stay at top of mind, increasing compliance and reducing HAIs,” says Bergin.

4. Many facilities simply don't provide enough opportunities for staff members to wash their hands between resident contact and other chores, experts say.

“Driving compliance to 100% is an ongoing challenge. Why? There are plenty of reasons and excuses, including the classic ‘too busy' and ‘supplies/equipment not readily available at point of care,'” observes Elaine McGowan, BSN, RN, CWCN, vice president of clinical affairs for Dermarite.

Ensuring adequate numbers of handwashing stations with sinks, paper towels or dryers and wall-mounted alcohol hand gel dispensers is essential. Want to drive compliance even more? Involve staff (including housekeeping) in actual product selection, says Pugliese. 

And don't err by allowing staff to rely on gloves as a handwashing substitute. 

5. One very effective tactic is to grab a UV light. 

“Some organizations have used substances like ‘Glo Germ,' which is only visible under a black light,” says Pugliese. “It also can be placed on surfaces near patients and if they're not washed properly, can show up if you use a black light. It helps reinforce to staff how contaminated their hands are and whether they washed.”