Nurses are noticeably more likely to comply with hand-washing guidelines than doctors, according to a new study in The Lancet Infectious Diseases.
According to the World Health Organization (WHO), poor hand hygiene contributes to millions of health care-associated infections each year, causing hundreds of thousands of preventable deaths. In the new Lancet study, an international team of researchers aimed to determine the effectiveness of WHO's Hand Hygiene Program, an education initiative that has been implemented in 168 countries and includes hand hygiene guidelines.
Researchers analyzed hand hygiene across low-, mixed-, and high-resource hospital settings in five countries: Africa, Costa Rica, Italy, Pakistan, and Saudi Arabia. Overall, the program significantly improved compliance with hand- washing guidelines, from 51% before the program started to 67% two years after. Alcohol-based hand rubs were found to be a key factor in practice improvement in low- and middle-resource settings.
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The researchers noted that nurses had the highest hand-washing compliance across all pilot sites before the intervention. Specifically, 71% of nurses complied with the guidelines, compared with 60% of doctors. Even after the WHO program was implemented, compliance rates remained higher among nurses than physicians at nearly all of the 43 hospitals in the study.
Expert: More must be done to improve hand hygiene
"The program provides health care workers with global and local support for the first time," said University of New South Wales (UNSW) professor Mary-Louise McLaws, a study co-author who helped draft the WHO Hand Hygiene Guidelines. She added, "The introduction of awareness of hand hygiene and simple resources is a great success with very little financial burden to each country."
McLaws acknowledged that the WHO program was "just the first step," and new strategies will be required to further improve hand hygiene. "The next phase will be harder—changing entrenched poor hand hygiene behavior in some health care workers who have yet to respond to the program," she added (Cheng, Counsel & Heal, 8/23; Medical Xpress, 8/23; UNSW release, 8/23).