“Have you washed your hands?”
It’s not just the first question out of parents’ mouths when their kids walk through the door after school. In the context of this winter’s particularly challenging flu season, hand-washing been a practice at the top of everyone’s minds.
Perhaps coincidentally, hand hygiene also made the news this month for another reason. On January 1, the Joint Commission announced that going forward the commission will issue citations to hospitals that fail to adhere to hand hygiene protocols. These citations will be issued if, during an on-site visit, a surveyor observes poor hand hygiene behavior.
This change increases the stakes associated with hand hygiene for US healthcare organizations. In fact, it’s a notable increase. For over a decade, all healthcare organizations have been required to have a hand hygiene program in place. However, this announcement now puts the enforcement of and adherence to these policies in the spotlight.
Although healthcare organizations are required to have a program, having one in place hasn’t necessarily translated to complete adherence. The Centers for Disease Control and Prevention (CDC) estimates that providers may need to clean their hands up to 100 times in a 12-hour shift to meet best practices. According to the CDC, “Studies show that some healthcare providers practice hand hygiene less than half of the times they should.”
Poor hand hygiene practices are directly linked to hospital acquired infections (HAI). According to the CDC, there are as many as 722,000 cases of HAIs in US acute care hospitals each year and as many as 75,000 associated deaths. And while it’s unclear how many cases are tied to hand hygiene, it is a preventable source of these infections.
Indeed, in the statement announcing the new citations, the Joint Commission wrote, “While there are various causes for HAI, the Joint Commission has determined that failure to perform hand hygiene associated with direct care of patients should no longer be one of them.”
What’s next for hospitals?
In the wake of the Joint Commission announcement it’s clear that hospitals will be held more accountable to their hand hygiene programs.
One way to monitor whether staff are keeping to the program is using hand hygiene audits. In many organizations, these consist of a staff member rounding on a floor or unit and documenting the hand hygiene practices that they witness – in some cases it’s as simple as writing it down on a piece of paper with a clipboard.