"Clean hands save lives," says Lisa McGiffert, Director of Consumers Union's Stop Hospital Infections campaign . McGiffert continues, "Unfortunately, most hospitals have a poor track record when it comes to making sure caregivers are protecting patients from infections by cleaning their hands properly."
The CDC says the use of gloves does not eliminate the need for hand hygiene. Likewise, the use of hand hygiene does not eliminate the need for gloves. Gloves reduce hand contamination by 70 percent to 80 percent, prevent cross-contamination and protect patients and health care personnel from infection. Handrubs should be used before and after each patient just as gloves should be changed before and after each patient.
A serious affliction patients are at risk for are group A streptococcal bacterial infections. They can cause a variety of health problems, ranging from a mild skin infection or sore throat to life-threatening conditions such as toxic shock syndrome and necrotizing fasciitis, commonly known as flesh-eating diseases.
According to repeated studies on the healthcare industry hand hygiene compliance rates in most hospitals are unacceptably low - usually below 50 percent. That means, on average, doctors, nurses and other health care workers are failing to clean their hands properly with over half of their patients. A recent survey by the Leapfrog Group found that only 35.6 percent of all hospitals have proper hand hygiene policies recommended by the CDC in place.
Dr Jean Turner, chief executive of the Scotland Patients' Association said in a newsscotsman.com report, "There is no excuse for not having basic cleanliness.....It's horrific that it is taking so long to get these figures down. This problem needs to be addressed because nobody wants to go into hospital and come out worse off."
Research shows that bacteria causing infections is often transmitted by the unwashed hands of health care workers who have touched a patient colonized with bacteria or a surface in the patient's environment that is contaminated. Caregivers who leave the bedside of a colonized patient without following proper hand hygiene can carry hundreds of thousands of units of bacteria on their hands.
Even if caregivers wear gloves while caring for such patients, they sometimes contaminate their hands when removing gloves covered by bacteria.
According to the largest hospital-wide survey of health care workers conducted on this subject, compliance with proper hand hygiene practices was lowest in intensive care units and during procedures that carry a high risk of bacterial contamination. Other studies have found a connection between poor hand hygiene and understaffing or overcrowding at hospitals.
"Patients expect hospital caregivers to have clean hands, but this expectation is not always met," said McGiffert. "One way to restore patient confidence is for hospitals to come clean by disclosing their hand washing compliance rates. Almost every hospital in the country has conducted hand hygiene campaigns in the last few years and now it's time for them to show us the results."
Researchers say nearly two million patients develop infections while being treated for other conditions in the hospital every year. This results in patients needing extra care and having longer hospital stays resulting in billions of dollars to the health care bill paid by insurers, consumers, and taxpayers every year.
In a recent report based on data collected from its hospitals, Pennsylvania found that insurers paid nearly $46,000 more for patients with infections than for patients without infections. Dr. John A. Jernigan, Chief of Interventions and Evaluations at the CDC, has said that these infections result in up to $27.5 billion in additional hospital-related expenses annually.
The CDC is asking health care facilities to develop and implement a system for measuring improvements in adherence to these hand hygiene recommendations.
Some of the suggested performance indicators include: periodic monitoring of hand hygiene adherence and providing feedback to personnel regarding their performance, monitoring the volume of alcohol-based handrub used/1000 patient days, monitoring adherence to policies dealing with wearing artificial nails and focused assessment of the adequacy of health care personnel hand hygiene when outbreaks of infection occur.
