Today in the chart

You Wash Your Hands Regularly At Work — But How Often Do Your Patients?

We know you scrub your hands, but do patients in your facility know how often they should be washing their hands during their stay?

Credit: Jenny K.

Regardless of your healthcare setting, you know you should lather up and scrub your hands vigilantly multiple times a day. After all, it’s protocol and protects the patients surrounding you. But do patients in your facility know how often they should wash their hands during their stay?

A new study by the University of Michigan reveals that spelling this out for patients could prevent them from developing illnesses caused by multidrug-resistant organisms (MDRO). Why? While healthcare providers’ hands are the most common ways patients are infected with MDROs (they contaminate about 5 percent of HCPs’ hands), objects around hospital rooms, like call buttons, tray tables, and bed controls, also are laced with MDROs.

What Did the Study Find?

“While the burden of preventing infections has largely been borne by HCP, our study shows that patient hands are an important reservoir and play a crucial role in the transmission of pathogens in acute care hospitals,” wrote the authors of the study, published in Clinical Infectious Diseases. “Thus, patient hand hygiene protocols should be implemented and tested for their ability to reduce environmental contamination, pathogen transmission, and healthcare-associated infections as well as to increase meaningful patient engagement in infection prevention.”

To come to this conclusion, researchers made more than 700 visits to the rooms of newly admitted (within 24 hours of arrival) general medicine inpatients at two hospitals in southeast Michigan. In these visits, they asked patients to enroll in the study and took samples from their bodies and the surfaces in their rooms. Researchers sought to discover if the strains of MRSA bacteria on the patients’ hands matched the strains in their rooms, which they did most of the time. This finding suggests transfer to and from the patient was occurring.

Of the 399 patients tested, 14 percent had the “superbug” antibiotic-resistant bacteria on their hands or nostrils. Another 6% who didn’t have MDROs on their hands when initially hospitalized tested positive for them later on.

Besides MRSA (methicillin-resistant Staphylococcus aureus), researchers were looking for VRE (vancomycin-resistant enterococcus) and RGNB (resistant Gram-negative bacteria). All of these bacteria have developed the ability to survive attempts to kill them with antibiotics because of overuse of antibiotics.

The study authors note that “in emerging healthcare systems where there is emphasis for early mobility, financial penalties for adverse events related to immobility and falls, and frequent treatment or procedures out of the room, patient hand contamination can have significant implications on MDRO transmission with both near and far environmental surfaces.”

What Can Healthcare Providers Do?

Additional research in this area is warranted, the study authors say: “Whether patient hand hygiene interventions and enhanced patient engagement can reduce environmental contamination, MDRO transmission, and nosocomial infections merits further evaluation.” They add, “Our observations suggest that at the minimum, patient hand hygiene programs should be targeted to MRSA-infected patients as an additional infection prevention strategy.”

Instead of more research and a formalized patient hand-washing program at your workplace, lead author Lona Mody, MD, MSc, recommends washing your hands in front of patients and spending “a few minutes to relay … how important it is for them to do the same.”

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