Handwash Study In The ER

Compliance Problem in Hospitals

After past studies revealed a 60% compliance rate for handwashing after patient contact, in other parts of the hospital, The Methodist Hospital did a handwashing study of the Emergency Room.

The Approach: observation of all personnel working with patients
The Participants: Emergency nurses, faculty, and resident physicians

Everyone in the ER was informed that they were the subject of a study and that an observer would be taking notes and monitoring their activities. They were not told that their compliance of handwashing was the focal point of the study.

The Result

Eleven faculty, 11 resident physicians, and 13 emergency nurses were observed.

  • Of 409 total contacts, 272 were clean, 46 were dirty, and 91 were gloved.
  • Hand washing occurred after 32.3% of total contacts (SD, 2.31%).
  • Nurses washed after 58.2% of 146 contacts (SD, 4.1%)
  • Residents washed after 18.6% of 129 contacts (SD, 3.4%)
  • Faculty washed after 17.2% of 134 contacts
  • Hand washes occurred after 28.4% of 272 clean contacts
  • The number of years of clinical experience was not significantly related to hand-washing frequency (P = .82).
  • Soap and water were used in 126 of the hand washes, and an alcohol preparation was used in the remaining six.

Conclusion

·There is major room for improvement in handwashing compliance in the ER of this hospital and most likely others as well.

·Nurses did better than doctors when it came to handwashing compliance.

·Reasons for noncompliance were attributed to the large number of patient contacts and time constraints.

·Strategies for improving compliance need to be explored.

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