Approximately one in five U.S. health facilities don't make alcohol-based hand sanitizer available at every point of care, missing a critical opportunity to prevent health care-associated infections, according to new research from Columbia University School of Nursing and the World Health Organization (WHO) published in the American Journal of Infection Control. The study, which examined compliance with WHO hand hygiene guidelines in the U.S., also found that only about half of the hospitals, ambulatory care, and long-term care facilities had set aside funds in their budgets for hand hygiene training.
A research team jointly led by Laurie Conway, RN, MS, CIC, PhD student at Columbia Nursing, and Benedetta Allegranzi, MD, lead of the WHO infection control program Clean Care is Safer Care, surveyed compliance with WHO hand hygiene guidelines at a sample of 168 facilities in 42 states and Puerto Rico. Overall, 77.5% of facilities reported that alcohol-based sanitizer was continuously available at every point of care, the study found. About one in ten facilities reported that senior leaders such as the chief executive officer, medical director, and director of nursing didn't make a clear commitment to support hand hygiene improvement, according to the study.
"When hospitals don't focus heavily on hand hygiene, that puts patients at unnecessary risk for preventable health care-associated infections," says Conway. "The tone for compliance with infection control guidelines is set at the highest levels of management, and our study also found that executives aren't always doing all that they can to send a clear message that preventing infections is a priority."
Hand hygiene is critical to preventing health care-associated infections, which kill about 100,000 people a year in the U.S. and cost about $33 billion to treat. The Centers for Disease Control and Prevention issued guidelines for hand hygiene in 2002, and the WHO followed suit in 2009.
"The survey also shows that facilities participating in the WHO global hand hygiene campaign achieved a higher level of progress," says co-author Prof. Didier Pittet, MD, MS, Director, Infection Control Program and WHO Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland. "While hand hygiene compliance is the responsibility of every health care worker, U.S. health care facilities would certainly benefit from coordinated national and sub-national efforts aimed at hand hygiene improvement. They would also gather innovative ideas and trans-cultural approaches by participating in global efforts such as the WHO campaign."
- Benedetta Allegranzi, Laurie Conway, Elaine Larson, Didier Pittet. Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities. American Journal of Infection Control, 2014; 42 (3): 224 DOI: 10.1016/j.ajic.2013.11.015
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