A spike in the number of hand hygiene deficiencies noted in nursing homes is linked to inadequate staffing levels, new research reveals.

Between 2000 and 2002, nursing home inspectors issued hand hygiene deficiencies in fewer than 7.4% of facilities, but that number jumped to 12% by 2009, according to researchers who analyzed nursing home survey data collected between 2000 and 2009.

The study’s lead author, Nicholas Castle, Ph.D., said a couple of factors account for this increase. Nursing homes with proportionately fewer RNs, LPNs and aides had significantly more deficiencies than facilities with more staff. Facilities in states with lower Medicaid reimbursement rates also are significantly more likely to have hand-washing lapses.

Castle told the New York Times that as awareness for healthcare-acquired infections has grown, nursing home inspectors are becoming increasingly aggressive about looking for lapses in hand hygiene protocol and reporting it.

The study was published in the August issue of the Journal of Applied Gerontology.