Patient education – crucial for good hand hygiene

The contribution that good hand hygiene practice can make to reducing healthcare-associated infections (HAIs) is well-known and widely acknowledged. Over recent years the focus has been on raising awareness and improving hand hygiene practices and improvement culture for healthcare workers, especially around the World Health Organisation’s (WHO) ‘Five Moments for Hand Hygiene’.

We rightly expect the hospitals and facilities that treat us and our loved ones to be hygienically clean, both in terms of the physical surroundings, and of the doctors, nurses, surgeons and other staff who care for us. However, what about the role of patients and visitors?

Patients and visitors can often be overlooked in the drive to reduce HAIs through the practice of good hand hygiene. They are sometimes targeted specifically, such as when outbreaks of norovirus, the winter vomiting bug, start to close hospital wards. This has a negative impact on a hospital’s ability to function, and also poses a serious threat to the very young and the very old, who can suffer severe complications as a result of contracting it.

In my experience, most patients and visitors are aware of the part they can play in reducing the spread of HAIs through practising good hand hygiene, but this is sometimes hampered by a lack of easy access to hand hygiene products.

Healthcare providers are wise to ensure that patients and the public can achieve good hand hygiene by providing a broad range of options in terms of formulations and dispensing systems. Personal preferences around the look and feel of hand care products can sometimes prove to be a barrier to using them, so providing choice is crucial.

Dispensers can be wall mounted, free-standing, push-activated or touch-free. Soaps can come in gel or foam format, with or without fragrance; and hygienic hand rubs can also provide another level of protection in addition to washing hands. The entrances and exits to wards, as well as other public spaces such as waiting rooms and eating areas are key places to target, not just with the means to clean and sanitise hands, but also to educate and inform.

Eye-catching signage, posters and other visual displays can help greatly, and good hand hygiene companies can offer sound advice on the most effective approaches, and provide materials, based on their knowledge of the sector.

Anecdotal feedback suggests that patients do not clean their hands frequently during hospital stays, either when using washrooms, before meals, or on entering and exiting their room/ward. Most of the published studies have been conducted on the hand hygiene of healthcare workers, but very little that focuses on patients and their visitors. This is an area where GOJO sees the need for a greater focus in the future.

Education, as mentioned previously, is a good place to start. Are new admissions given information on the importance of hand hygiene, and the best ways to achieve it? The most effective education methods are centred on the learner, so involving patients and visitors in the development of such programmes will ensure that communication materials are relevant and easy to understand.

However, education is only part of the solution, because we also need to make it easy for patients and visitors to comply. Asking fundamental questions such as: are patients provided with the means to clean their hands before eating if they are bed-ridden; and do they have ready access to sinks and/or hygiene hand rubs, could reveal some interesting results, and quickly identify areas for improvement.

The provision of hand hygiene rubs also helps to increase patient empowerment, encouraging the involvement of patients and carers in choosing their healthcare and treatment options and being active participants in, not passive recipients of, the care process.

Great progress has been achieved in making hand hygiene among healthcare workers the norm – and we all need to ensure that this goal is also reached when it comes to good hand hygiene practises for patients and visitors.