Patient safety depends on many preventative steps, and many of those steps must be followed meticulously. The Society for Healthcare Epidemiology of America collaborated with several organizations to address hand hygiene and infection control in the recently released Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene: 2022 Update, one in a series of expert guidance documents known collectively as the Compendium. The report, published in the journal Infection Control & Hospital Epidemiology, reinforces how the simplest act of hand washing and proper hand hygiene can have a significant impact on patient safety.

During this year’s Patient Safety Awareness Week, Dr. Emily Sickbert-Bennett, in the Division of Infectious Diseases at UNC School of Medicine, and one of the authors of the report, provided Minority Nurse with additional insight about hand hygiene.

Healthcare workers know that hand washing helps keep them safe and helps prevent the spread of germs in the patient population. “Every episode of hand hygiene can interrupt the spread of germs between patients, between patients and healthcare personnel, and between the contaminated environment and patients,” says Sickbert-Bennett. “Healthcare personnel need to wash their hands dozens of times throughout their workday as they have complex interactions with very sick patients.”

Despite knowing how effective simple soap and water (or alcohol-based hand sanitizer) is at preventing the spread of germs, the study found that complete hand washing guidance isn’t always followed. In an intense and rushed environment, it’s not simply forgetfulness or a lack of intent that sometimes prevents proper hand hygiene. “The biggest factor is likely time – which impacts our ability to do hand hygiene often enough and thoroughly enough,” says Sickbert-Bennett. “An important way to mitigate this is to make sure that hand hygiene supplies are easily accessible in areas where patient care is occurring.”

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And education about the proper techniques for keeping hands clean is essential, particularly considering that the report cites research that shows only 7% of healthcare personnel effectively clean the entire surface of their hands with thumbs and fingertips being the most frequently missed. The report also notes the potential for bacteria being difficult to remove if providers have certain fingernail polish or applications such as acrylic nails. Guidance around the need for proper cleaning practices, even if gloves are also worn, is also noted.

“Hand hygiene programs that use reminders to reinforce the habit of hand washing at the right times have been shown to be effective,” she says. “Nurses can play an important role in hand hygiene and patient safety by reminding their colleagues to clean their hands throughout the day as they take care of patients.”

Commitment from the top levels of organizations will also move the needle in the right direction. The report notes that nurses and healthcare personnel need easy access to hand-cleaning supplies and also moisturizing lotions that are in compliance with hygiene safety standards. All that hand washing takes a toll on the skin and cracks can also lead to infection. That means plenty of access to soap and water and also wall mounted pumps containing alcohol-based hand sanitizer instead of nurses carrying hand sanitizer in bottles in their pockets.

As healthcare providers, nurses can care for themselves and their patients with increased attention to an essential tool–their hands.

Julia Quinn-Szcesuil
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