Hospital visitors and staff are greeted with hand sanitizer dispensers in the lobby, by the elevators and outside rooms as reminders to wash their hands to stop infections, but just how clean are patients' hands?
A study led by McMaster University researcher Dr. Jocelyn Srigley has found that hospitalized patients wash their hands infrequently. They wash about 30 per cent of the time while in the washroom, 40 per cent during meal times, and only three per cent of the time when using the kitchens on their units. Hand hygiene rates were also low on entering and leaving their hospital room, at about three per cent and seven per cent respectively.
"This is important because getting patients to wash their hands more could potentially reduce their risk of picking up infections in the hospital," said principal investigator Srigley, an assistant professor of medicine at McMaster's Michael G. DeGroote School of Medicine and the associate medical director for infection prevention and control at Hamilton Health Sciences.
The research was published online in Infection Control and Hospital Epidemiology.
Much is known about the importance of health care worker hand hygiene in preventing infections in hospital, but there has been little emphasis on the hand hygiene behaviour of patients as a way to reduce the spread of infection.
Srigley and her team looked at the hand hygiene of 279 adult patients in three multi-organ transplant units of a Canadian acute care teaching hospital over an eight-month period. The researchers used new electronic hand hygiene monitoring technology involving sensors on all soap and sanitizer dispensers, to assess this behaviour. The same system was used by the team in its recent study that discovered fewer health care workers wash their hands when not being watched.
Organisms such as Clostridium difficile (C. difficile) or norovirus can survive on skin and surfaces, contaminate patients' hands, and then be ingested, leading to infection. Similarly, MRSA (methicillin-resistant Staphylococcus aureus) and respiratory viruses could also be acquired by patients from the environment by way of their hands, the authors noted.
Srigley said that with the current lack of focus on patient hand hygiene, this study's results are not surprising. Furthermore, it is already known that health care worker hand hygiene is far from ideal despite intensive efforts to improve it through education, promotional materials and feedback.
"At the hospital where this study was conducted, patients were not given any specific information about hand hygiene," said Srigley.
"We can't expect patients to know when to wash their hands if we don't inform them, so it's not surprising that they wash their hands infrequently. In particular for washing hands when entering and exiting their room, it's not something that I would expect patients to think of doing unless they were educated and reminded to do that."