November 01, 2019
2 min read

Hand hygiene adherence rates ‘very low’ among staff in nursing homes

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Researchers observed low rates of overall hand hygiene adherence among health care workers at six skilled nursing facilities, according to findings published in a recent study. They also found that glove use and job title were associated with higher hand hygiene adherence.

“Hand hygiene is the single most effective way of preventing infections in hospitals and nursing homes. Despite this, hand hygiene rates have historically been low, especially in nursing homes,” John P. Mills, MD, assistant professor in the division of infectious diseases at Michigan Medicine, told Infectious Disease News. “In order to improve hand hygiene in these facilities we first need to understand why health care workers (HCWs) don’t always wash their hands.”

Mills and colleagues aimed to determine factors that could influence hand hygiene among HCWs in nursing homes — more specifically, whether the type of patient care and glove use affected hand hygiene — by observing HCWs during routine care.

According to Mills, they found that hand hygiene rates in general were very low and consistent with the results of prior studies performed in nursing homes, with 27% hand hygiene adherence before patient care and 46% after.

“All health care facilities should strive for 100% hand hygiene adherence. It is common for HCWs to come into contact with bacteria during routine patient care and hand hygiene is an easy and effective way to remove bacteria from our hands and therefore prevent the spread of these bacteria to other patients,” Mills said.

Additionally, the study showed that HCWs were two to three times more likely to perform hand hygiene if they wore gloves before patient care (OR = 2.55; 95% CI, 1.44–4.54) and after patient care (OR, 3.11; 95% CI, 1.77–5.48), although hand hygiene rates varied considerably based on the activity performed. For example, rates were very low after taking vital signs or performing physical therapy and much higher after performing incontinence care, according to Mills.

The study also revealed that HCWs picked up antibiotic-resistant bacteria on their hands after 6.3% of patient interactions, although it was before washing their hands.

“Hand hygiene rates are currently very low in some nursing homes and HCWs occasionally acquire antibiotic-resistant bacteria on their hands. This can lead to patient-to-patient transmission of resistant bacteria which have the potential to cause infections, particularly among frail patients,” Mills concluded. “We feel that hand hygiene education must be tailored to the role and responsibilities of the individual HCW and should involve monitoring and feedback to be more effective.” – by Caitlyn Stulpin

Disclosure: Mills reports no relevant financial disclosures.