In 1847, Ignac Semmelweis also known as the father of hand hygiene established the link between childbed fever and unclean hands. It took the world 20 years to recognize his discovery after germ theory of disease by Louis Pasteur and concept of antisepsis by Joseph Lister.
Now in 2023, what is the progress on that front?
More than 176 years later, the world is still struggling with consistent implementation of hand hygiene. According to World Health Organization (WHO), in some low-income countries only 1 in 10 health workers practices proper hand hygiene while caring for patients at high risk of health care-associated infections in ICU. In 2018 only 45% of low-income countries had a functional national IPC programme compared to 53-71% of middle and high-income countries and dedicated budget to support it was available in only 5% of low-income countries as opposed to 18 and 50% of middle and high-income countries.
What are barriers to hand hygiene?
Barriers to hand hygiene in healthcare facilities can be divided into two main categories: individual-level and institutional-level barriers.
Individual-level barriers include:
Lack of knowledge or awareness of the importance of hand hygiene.
Forgetfulness.
Perception that hand hygiene is inconvenient or time-consuming.
Fear of skin irritation or dryness.
Cultural beliefs or practices.
Institutional-level barriers include:
Lack of access to hand hygiene supplies, such as soap, water, or hand sanitizer.
Poorly designed facilities, such as sinks that are too far away or not conveniently located.
Heavy workload or staffing shortages.
Lack of support from management.
Lack of training or education on hand hygiene.
In addition to these general barriers, there are also some specific barriers to hand hygiene in healthcare facilities, such as:
Wearing gloves. Healthcare workers may feel that wearing gloves eliminates the need for hand hygiene, but this is not the case. Gloves can become contaminated with germs, and healthcare workers need to wash their hands after removing gloves.
Working in busy or stressful environments. Healthcare workers may be more likely to skip hand hygiene when they are busy or under stress.
Working with patients who have infectious diseases. Healthcare workers may be reluctant to touch patients with infectious diseases, even if they are wearing gloves. This can lead to them skipping hand hygiene after caring for these patients.
It is important to note that these barriers are not mutually exclusive. For example, a healthcare worker may be more likely to skip hand hygiene if they are working in a busy environment and do not have easy access to hand hygiene supplies.
There are a number of things that can be done to address the barriers to hand hygiene in healthcare facilities. These include:
Providing healthcare workers with training and education on the importance of hand hygiene.
Making hand hygiene supplies readily available throughout the facility.
Designing facilities in a way that makes it easy for healthcare workers to perform hand hygiene.
Creating a culture of safety where healthcare workers feel comfortable speaking up if they see someone not performing hand hygiene.
Providing healthcare workers with support and encouragement to practice good hand hygiene.
By addressing the barriers to hand hygiene, healthcare facilities can improve patient safety and reduce the spread of healthcare-associated infections.
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