Even after a clean hand campaign, less
than half of the doctors studied washed
their hands after interacting with potentially
infectious patients.
Image: iStockphoto
A campaign to improve hand hygiene in NSW public hospitals has been a success, but doctors are still lagging behind nurses when it comes to keeping their hands clean, collaborative research from the University of New South Wales (UNSW) and the NSW Clinical Excellence Commission has found.
A series of four landmark studies found that nurses were far better than doctors and other allied health workers in matters of hand hygiene.
The campaign was conducted between February 2006 and February 2007 and resulted in an overall improvement in hand hygiene. However, improvement was not uniform.
The proportion of nurses who cleaned their hands after patient interaction rose from 54.5 percent before the campaign, to just over 65 percent after the end of the campaign. During the same period, doctors’ figures rose from 29.6 percent to just under 39 percent.
Allied health workers’ hand hygiene rates went from 40 to 48 percent.
The findings suggest much more needs to be done to educate doctors and allied health workers about the benefits of clean hands and to empower nurses to initiate change.
“This hand hygiene rate among doctors and other allied health workers is a wake up call,” said study author, director of Public Health Programs at UNSW, Associate Professor Mary-Louise McLaws.
“Doctors are going to be horrified when they see these data. No doctor thinks ‘I’m going to work today to infect my patients’.”
The World Health Organisation (WHO) has identified hand hygiene as a key element in reducing rates of hospital acquired infections, which affect as many as 200,000 Australians each year – or one in 10 hospital admissions.
The studies, which appear in a special supplement in the latest issue of the Medical Journal of Australia, report on the campaign Clean Hands Save Lives, which was introduced into NSW public hospitals in 2006. Staff champions and project leaders were recruited to help implement a hand hygiene culture change that included making alcohol-based hand rub (AHR) available to all staff.
Associate Professor McLaws, who is epidemiology adviser to the WHO First Patient Safety Challenge pilot project on hand hygiene and hospital acquired infections, said peer behaviour was a strong influence.
“Previous studies we’ve done show that nurses look to doctors for their hand hygiene compliance behaviour, yet it is doctors who are letting the side down,” she said.
“We need to empower nurses to be strong advocates for their patients and to guide and remind doctors who enter their wards to cleanse their hands. This is such an important issue that nurses should be enabled by the hospitals to come down hard on any clinical staff, whether they are an intern, or a senior medical consultant.
“At the same time we need research to target an education campaign specifically focusing on doctors – by doctors to doctors – because they’re just not getting it yet.”
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