Issues related to the availability of alcohol-based hand sanitizer at the point of care and training about the importance of hand hygiene among workers at long-term care facilities, hospitals and ambulatory care settings indicate missed chances to prevent healthcare-associated infections (HAIs), according to new research from the Columbia University School of Nursing and the World Health Organization (WHO). Senior leadership at facilities can be part of the solution, they say.
Alcohol-based hand sanitizer is not available at every point of care in about 20 percent of U.S. healthcare facilities, according to the study, published in the American Journal of Infection Control, and only about 50 percent of healthcare facilities had set aside funds in their budgets for hand hygiene training. Also, about 10 percent of facilities reported that senior leaders such as the CEO, medical directors and directors of nursing did not make a clear commitment to support hand hygiene improvement.
"The tone for compliance with infection control guidelines is set at the highest levels of management," says Laura Conway, RN, MS, CIC, a PhD student at Columbia. She and Benedetta Allegranzi, MD, leader of the WHO infection control program Clean Care is Safer Care, surveyed adherence to WHO hand hygiene guidelines at a sample of 168 facilities in 42 states and Puerto Rico. "Our study also found that executives aren't always doing all that they can to send a clear message that preventing infections is a priority," Conway added.
Hand hygiene is critical to preventing HAIs, which kill about 100,000 people a year in the United States and cost about $33 billion to treat. The Centers for Disease Control and Prevention issued guidelines for hand hygiene in 2002, and the WHO issued guidelines in 2009.