Healthcare environments are notoriously chaotic. Hospitals and clinics are bustling with activity, housing both the sick and the immunocompromised, often under the continuous threat of hospital-acquired infections (HAIs). These challenges are further compounded by issues such as short staffing, increasing burnout, and heightened patient volumes.
In such a setting, aiming for 100% hand hygiene compliance might seem like an impossible standard—and indeed, it is. While some hospitals managed to achieve compliance rates over 90% during the pandemic, research has shown that such high levels are nearly impossible to sustain over the long term. In one study conducted during the pandemic, many hospitals achieved greater than 90% hand hygiene compliance, but within six months, that rate dropped to 51%.
It’s important to acknowledge that absolute perfection in hand hygiene is unrealistic. Healthcare workers are human, not machines, and expecting robotic consistency under intense pressure is unrealistic. However, this doesn’t mean efforts to improve hand hygiene should be relaxed. On the contrary, even modest improvements can significantly reduce the incidence of HAIs. Recognizing this, the Joint Commission has shifted its focus from stringent compliance targets to fostering overall improvements in hand hygiene practices.
Recent discussions in publications like the Wall Street Journal and Becker’s Hospital Review introduce the "85% rule," suggesting that aiming for this more attainable target might actually be more effective than striving for perfection. This idea is supported by research, including a study published in Nature Communications, which found that optimal learning occurs at about 85% accuracy for humans, animals, and artificial neural networks alike.
With this in mind, it's clear that while perfection isn't necessary to make progress, consistent and focused efforts are still required to manage and reduce HAIs effectively. This perspective brings us to explore four common barriers healthcare workers face in maintaining hand hygiene and the practical solutions that can help overcome these challenges.
Healthcare workers are constantly on the move, attending to emergencies and managing multiple patient needs in often understaffed environments. Despite the best intentions, the sheer unpredictability of the environment can result in missed opportunities for hand hygiene.
Healthcare workers frequently suffer from skin irritation due to repetitive hand washing and harsh soaps, which can deter them from adhering to necessary hand hygiene protocols. The constant exposure to chemicals and the physical act of washing can damage skin over time, making it painful and potentially compromising the skin's natural barrier.
A significant barrier to hand hygiene compliance is a lack of awareness. Some healthcare workers may not fully understand the importance of handwashing and its impact on patients. They also may not be aware of the specific times and instances to perform hand hygiene, such as entering or exiting a patient's room or before and after using gloves.
Additionally, there is often confusion about when to use hand sanitizer instead of soap. It is recommended to use hand sanitizer for quick cleansing when hands are not visibly soiled and to use soap for thoroughly cleaning visibly dirty or potentially contaminated hands.
Forgetting to perform hand hygiene at critical moments is a common barrier, especially in fast-paced healthcare settings where staff are frequently interrupted or juggling multiple tasks. This oversight can significantly impact infection control efforts.
By understanding and addressing the common barriers to hand hygiene, healthcare facilities can implement effective strategies to enhance compliance. These solutions include utilizing technology like SwipeSense for reminders and education, fostering a team environment, and implementing strategies to prevent skin irritation.
Ultimately, these efforts not only improve patient outcomes but also protect healthcare workers by reinforcing the critical role of hand hygiene in preventing infections.