ICT spoke with John M. Boyce, MD, hospital epidemiologist and chief of infectious disease at Saint Raphael Healthcare System in West Haven, Conn., and Gina Pugliese, RN, MS, vice president of the Premier Safety Institute, about how to boost hand hygiene compliance rates in healthcare institutions. Boyce presented Premier’s Advisor Live program, “Improving Hand Hygiene: An International Collaboration” in early May; the audiofile and slides are available by clicking HERE.
ICT: You have been so instrumental in shaping hand hygiene guidance documents, so what do you believe is the reason for the disconnect we see between theory and practice? Do people know what to do but just don’t do it? Is a behavioral approach necessary in conjunction with continued education?
Boyce: Although most healthcare workers (HCWs) have heard about the importance of hand hygiene, some still are not clear on the major indications for hand hygiene, as outlined in the World Health Organization guideline. Also, cleaning hands when they are visibly dirty or contaminated, and doing so after touching potentially colonized or infected patients are inherent behaviors that many HCWs do automatically. In contrast, cleaning hands before touching patients and after touching only environmental surfaces near a patient are not inherent behaviors among HCWs, and warrant increased educational efforts. Failure of high-level administrators to create and support a culture of safety and accountability contribute to low levels of compliance.
