WASH YOUR HANDS, GEOFFREY

There is an old Australian television advertisement for Solvol. In the advertisement, a young boy is nagged to wash his hands. Here is the black and white advertisement that will be nostalgic for nurses of an age. Wash your hands, Geoffrey Be warned that the phrase used will stick around in your head for some time. But the message is clear – wash your hands.

PATIENT SAFETY COMPROMISED

Researchers from the University of New South Wales found that doctors and nurses failed to properly wash their hands when no one was watching.The researchers were looking at the Hawthorne effect with hand washing compliance. The Hawthorne effect occurs when behaviour is altered by the subjects of a study when they are aware that they are being observed. The compliance rate for handwashing dropped from 94 per cent to 30 per cent in one ward when human auditors stopped observing staff and an automated surveillance system kicked in. Compliance is based on the number of hygiene “moments”. SovolFishBook_GilbertPWhitly_MaryESoadyplate14AdvertizingSovolSoapThat is when handwashing or cleaning should have occurred, either before or after patient contact. Every patient has a right to expect that they will protected from contaminated hands. So wash your hands between each patient.

And remind your colleagues to do it as well. The safety of every patient is compromised when hands are not washed. Florence Nightingale exhorted nurses “to be careful to wash her hands very frequently during the day.” The message is still the same today.

SPEAKING UP

A Swiss study found that only half of the respondents in a survey said that they would speak up to an attending doctor who missed the hand disinfection prior to inspecting a wound. There are complex tradeoffs that nurses know only too well about why this occurs. Nurses need support from their organization’s leaders to improve the rate of hand washing. Without that support, most nurses would weigh up the consequences to themselves if they spoke up. When the focus should always be on the patient. Quality improvement as important as this will occur when nurses are clearly supported to do so.

To learn more about hand washing compliance rates,

McLaws, Mary-Louise, and Yen Lee Angela Kwok. “Hand hygiene compliance rates: Fact or fiction?.” American journal of infection control (2018)

Schwappach, David LB. “Speaking up about hand hygiene failures: A vignette survey study among healthcare professionals.” American journal of infection control (2018)