Study Reports Predictors of Poor Hand Hygiene in Emergency Department

Certain care situations — including bed location and type of health care working performing the care — result in poorer hand hygiene practice, according to a study publshed in Infection Control and Hospital Epidemiology.

“We found that receiving care in a hallway bed was the strongest predictor of … health care providers not washing their hands,” study author Arjun Venkatesh, MD, stated in a Society for Healthcare Epidemiology of America press release. Venkatesh added he hopes the finding will focus attention on infectious risks created by crowding in emergency departments.

The researchers performed the study in an urban, academic emergency department that reportedly receives more than 57,000 annual visits. Five trained observers and one infection control specialist conducted audits of hand hygiene compliance between January 2009 and April 2010 in 30-minute to 90-minute observation periods that varied between 7 a.m. and 2 a.m. in order to encompass all shifts during the week.

According to the study results, 5,865 hand hygiene opportunities were observed over 257 observation periods, with an overall compliance of 89.7%. After multivariate analysis, the team was able to identify independent predictors of lower rates of hand hygiene compliance. These predictors included observation unit environment, hallway bed location, the use of gloves, the type of health care worker involved and high room visibility.

The findings, according to the release, confirmed “many known contributors of poor hand washing practices,” including the wearing of gloves in lieu of hand washing. The study also found workers who transport patients between hospital departments and rooms were less likely to wash their hands when compared with other workers — a finding the authors attributed to these workers receiving less hand hygiene training than other workers.

For more information:

  • Venkatesh A, Pallin DJ, Kayden S, Schuur JD. Predictors of hand hygiene in the emergency department. Infect Control Hosp Epidemiol. 2011. 2011;32(11).

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