One in five U.S. health facilities don't put hand sanitizer everywhere needed to prevent infections, study finds

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."