Top 5 Barriers to Hand Hygiene Compliance Stem From Inconvenience


Despite various techniques that health care facilities use to facilitate 100% hand hygiene compliance from their health care workers, barriers still must be overcome.

Hand hygiene

Hand hygiene is vital to prevent spread of infections. (Adobe Stock)

Hand hygiene is key to preventing HAIs and SSIs in the health care facility. In fact, it is so important that the World Health Organization (WHO) has a World Hand Hygiene Day for infection preventionists to emphasize the impact of not washing one’s hands or using hand sanitizer. Yet, health care facilities still struggle to guard against lapsed compliance to their hand hygiene protocols.

However, despite the research, lectures, and other various methods to instill the importance of hand hygiene every time a health care worker (HCW) interacts with a patient and throughout the workday, according to recent research by GP PRO, a division of Georgia-Pacific dedicated to helping advance hygiene in health care and other market segments, 5 barriers inhibit HCWs from dependably complying with their facility’s hand hygiene protocol. All the reasons, across the survey results, were due primarily to inconvenience.

“Performing hand hygiene is the single most important step in breaking the chain of infection. The transfer of pathogens from surfaces is largely due to hand contact with surfaces,” said Sharon Ward-Fore, MS, MT(ASCP), CIC, FAPIC, an infection prevention consultant, located in Chicago, and a member of Infection Control Today’s® Editorial Advisory Board, told ICT® about this research. "Touching a contaminated surface can lead to cross contamination of patient care items, other environmental surfaces, self-contamination, and possible infection if you touch your face, mouth, or eyes. That's why we need to perform hand hygiene at every opportunity. HCP know the importance. It's up to everyone to remove barriers like those mentioned, to make hand hygiene as reflexive as breathing.”

According to the research, consisting of 100 respondents from November 4, 2021 to November 9, 2021, when HCW were asked why they were unable to comply with their facility’s hand hygiene policy consistently 100% of the time when using an alcohol-based hand rub, the top five ranked reasons included:

  • emergencies requiring immediate attention (66%);
  • a busy schedule or full workload (66%);
  • malfunctioning, broken or empty hand sanitizer dispensers (51%);
  • hands being full and, therefore, unable to access a dispenser (50%);
  • and difficulty sanitizing hands during glove-on/glove-off process (50%).

In addition, all of these reasons need managerial buy-in to be addressed and eliminated as Jan Dyer discussed in a recent ICT® article.

The authors of the study noted that when 1 respondent was asked why he/she believed the policies were not followed 100% of the time, he/she replied, “Short staffing. High patient ratios. Lack of support from admin. Admin asking staff for completion of time sensitive tasks without consideration for employee's time and workload. Burnout.”

Other techniques, including posters of WHO’s 6-step hand hygiene process, SafeHaven Personal Hand Hygiene System, and other web-based hand hygiene applications have demonstrated to improve HCW compliance as well; however, none show a 100% observance.

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