HAI

90,000 of the 98,000 patients who die each year in hospitals are due to HAI. These infections are preventable with closer attention to Hand hygiene and Infection Control guidelines by ALL health care workers(HCW). Traditional Infection Control looks for a denominator in infection rate. The new era of Patient Safety is asking to remove the denominator and approach ZERO HAIs. This will require more comprehensive Patient Safety/Infection Control programs that adequately address the significance of changing human behavior and the role OUR HANDS play in the spread of disease!

Yes, changing the hospital work environment to a “culture of safety”, is a bold step, but necessary in order to make the strides we are capable of in the health care arena to benefit our patients. This Hand Awareness Campaign can help expedite us to be able to achieve this goal, through the “genuine communication” strategy between peers and authority figures in health care, implementing social(causal) marketing strategies in hospital settings, and focusing on a simple technique (Hand Awareness) that is repeated upwards of 50-100 times per shift, providing many opportunities for staff members to hold each other accountable for the correct behavior.

 

Methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C.diff) and vancomycin resistant enterococcus (VRE) are three infections which complicate the inpatient stay of many patients. It has been shown that infection rates can be reduced by increasing healthcare worker compliance with hand hygiene1 and improved sanitization efforts.2Overall, infection rates for MRSA have declined over the past five years, but C.diff infections have increased over the past three years.3 With an increase in C.diff infections between 2001 and 2005 of 102%,4 it is imperative that we examine compliance with hand hygiene.

Despite how simple it is to maintain hand hygiene by using soap and water, or even an alcohol-based sanitizer, adherence to hand hygiene is often low, usually below 50%.5-7 Perhaps worst of all is that physicians typically have the lowest compliance of all healthcare workers.8 Gilbert et al found that the overall hand hygiene compliance for the surgical intensive care unit (SICU) was 51.6% and 47.2% for the medical intensive care unit (MICU). However, MICU nurses were more compliant with hand hygiene in contact precaution rooms than noncontact precaution rooms (66.7% and 51.6% respectively P < 0.05). Additionally they found that MICU nurses had a hand hygiene compliance rate of 87% when leaving patient rooms with contact precautions, as compared to 70% compliance when leaving patient rooms without contact precautions (P < 0.05).9

It has been shown that organisms can live on healthcare worker’s hands for several minutes following contamination.10Therefore, if hand hygiene is suboptimal or nonexistent, then colonization and transmission are more easily established. The implication of these low rates of hand hygiene compliance is increased rates of healthcare associated infections (HAIs) – infections that patients acquire as a result of inpatient healthcare. In 2002 there were 1.7 million HAIs in the United States11 and 3 million in Europe in 2006.12