October 1, 2004

VUMC awareness program set to promote hand washing

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photo by Dana Johnson

VUMC awareness program set to promote hand washing

Vanderbilt University Medical Center is preparing to launch a campaign to improve the hand hygiene of staff and faculty who provide patient care in the hospital and clinic.

Elements of the campaign are already under way in the Monroe Carell Jr. Children’s Hospital at Vanderbilt.

“Despite the hand’s well known role as the chief vehicle for the transmission of disease, studies find generally poor adherence to hand hygiene among health care workers,” said VUMC Chief Medical Officer C. Wright Pinson, M.D. “Our campaign is intended to promote staff and faculty awareness and a new level of adherence to this most fundamental infection control practice.”

According to the Centers for Disease Control, recent studies place hand hygiene adherence in hospitals at between 29 percent and 48 percent. Among reasons for poor hand hygiene commonly reported by health care workers are that hand washing causes irritation and dryness, that sinks are inconveniently located, and that they’re too busy to stop and wash their hands. Total adherence to hand hygiene is now emerging as a national patient safety goal, said F. Andrew Gaffney, M.D., VUMC chief quality and patient safety officer.

“Inadequate hand hygiene is considered the leading cause of health care-associated infections,” Gaffney said. “We will improve only when it becomes comfortable and expected for people to ask each other whether they’ve washed their hands, and our campaign is designed to help bring about that type of culture change across the hospital and clinic.”

The chief requirements of basic hand hygiene for health care workers include decontaminating hands before and after each patient contact, decontaminating hands before putting on gloves and after removing gloves, before handling medications and after handling contaminated objects. Artificial nails and excessively long nails are unhygienic in health care settings.

“It’s thought that 100 percent adherence to basic hand hygiene would reduce infection more than any other change we could make in hospitals,” said Associate Hospital Epidemiologist Thomas R. Talbot III, M.D., the leader of the campaign to improve hand hygiene at VUMC.

“Many people think hand hygiene is about self protection, not realizing the key role that it plays in patient safety,” Talbot said. “Many also don’t realize that unless your hands are visibly soiled, alcohol gel is at least as effective as soap and water, and it’s also less drying to your hands.”

Talbot said the committee behind the campaign includes staff and faculty from several corners of the Medical Center.

“In order for this campaign to work, we realized that a Medical Center-wide commitment was necessary. We knew that all groups would need to be involved to provide a more encompassing voice for this effort.”

The hand hygiene campaign is a facet of a VUMC infection control program that is becoming more aggressive. Talbot occupies a new faculty position devoted largely to infection control. In the past two years the number of infection control nurses has grown from three to five, and a sixth will soon be added.

“Beyond any benefits realized here at VUMC, we also want to advance infection control to provide a model for other medical centers,” Talbot said.

The campaign will officially kick off later this fall. Highlights include:

• Hand hygiene has been included in annual training requirements for faculty and staff who provide direct patient care.

• A education team has begun providing brief awareness sessions in patient care areas, with initial emphasis on inpatient areas.

• Scores of additional alcohol gel dispensers will be placed throughout the Medical Center.

• Various clinical leaders will be approached to serve as models of good hand hygiene.

• A team will monitor hand washing practices in the hospital and clinic.

• Signs reminding people to wash their hands will go up throughout patient care areas.

• Respiratory therapists will soon test the use of personal hand gel dispensers worn on belt clips.