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Sunday, January 31, 2010

Catching Hospital Workers Dirty-Handed

How diligent are YOU about making sure your health care providers wash their hands?

Catching Hospital Workers Dirty-Handed
by Gigi Douban

"Wash your hands" is a message Lindsey Ann Stone, a nurse at Baptist Princeton Hospital in Birmingham, Ala., and her colleagues have heard over and over again.

Stone ticks off the ways hand washing is promoted: "Through orientation, re-education; we have yearly updates that they put up, and bulletins and hand-hygiene pamphlets and posters. Everything that you can imagine, it's all over."

The standard protocol in hospitals is for doctors and nurses to wash their hands on the way in to see a patient, and on the way out. But that doesn't always happen — they get busy; they forget.
In fact, studies show that only about 40 percent of health care workers in the United States wash their hands as often as they should. So some hospitals are trying to monitor just how regularly their employees are washing up — by testing out new surveillance technologies.

Stone says she washes her hands a lot; she guesses at least 100 times a day. But her hospital's administrators aren't guessing — they have installed new devices to keep track.

With information transmitted wirelessly through a special badge Stone wears, the hospital can tell when she entered a patient's room, whether she washed her hands and whether she washed again on the way out. The information is sent to hospital officials, including the CEO.

When she first heard about the new system, Stone says she had mixed feelings.

"I was excited, but to be honest, I was a little nervous wondering how it was going to directly affect me as an RN," she says.

For one thing, she and her colleagues wondered how this information — a sort of nice and naughty list on hand washing — would ultimately be used.

"If they're habitually not complying, we can send them an e-mail or send them a text message, something that goes to them personally," says Harvey Nix, CEO of Proventix, the company that developed the monitoring system at Baptist Princeton.

Nix says the communication is meant to be more a gentle prod than punitive action. Still, most people aren't thrilled about being monitored.

The Centers for Disease Control and Prevention is trying to gauge how the surveillance affects health care workers. Focus groups are helping to tweak the technology, CDC epidemiologist Kate Ellingson says.

Researchers don't just want to know whether workers like it, Ellington says, but also the answers to questions like: "Do you see this as something that you would pay attention to? That would change your behavior?"

Improving hand hygiene among health care workers has been a real challenge, Ellingson says, but letting the problem slide comes at a price, too. According to the CDC, health care-associated infections kill about 100,000 Americans a year, at a cost of billions of dollars.


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