2020: Those who forget to sanitize face condemnation while Hospitals see reduced infections with hand hygiene monitoring investments

Since COVID-19, society has embraced a “new normal”, one where there is no longer doubt about the importance of hand hygiene. Before Wuhan became 2020’s most discussed Chinese city, hand hygiene was simply something that we performed after a toilet visit; though some people skipped hand hygiene in public toilets without fretting any shame.

Today, no one would dare to skip a hand wash in a public facility and if they did, they can rest assured of the condemnatory eyes of their peers to follow them as they exit the room. The same goes for places that were previously encouraged hand washing locations, but often not prioritized, such as at the morning buffet, entrance to stores, elevators or workspace buildings, which have now all been equipped with sanitizers to make it easy and convenient to perform hand hygiene for everyone. And it is working. Chile has recorded infection reduction, 1,134 seasonal respiratory infections this year, compared with 20,949 such infections during over the same time period last year (Hand Hygiene in the Post-COVID-19 Era).

For some industries rigid hand hygiene procedures have always been the standard that has been enforced, such as inspections of airplanes. Pharmaceutical laboratories and food processing companies have mandated strict guidelines and control measures in order to prevent contamination of drugs, food or even equipment. For instance, if a worker does not comply with procedures, and contaminates a production line, organizations could lose orders worth billions. The most heard of cases of noncompliance at food processing companies are those that result in consumers being poisoned by bacteria such as salmonella campylobacter or listeria. These companies see the majority of their contracts canceled, which for many have meant the end of their operation.

Another industry for which noncompliance is completely unacceptable is hospitals. An error in these buildings will most likely cost lives. Therefore, IT systems are put in place to help healthcare workers prevent errors. Hospitals are exceptionally good at monitoring these quality prevention measures. They have process, outcome and structure measures implemented in order to ensure that the entire treatment chain is carried out to the highest standard no matter the number of patients.

This is also why I was completely shocked when I found out that hospitals do not measure the quality of the most important metric everyone in the world is focusing on today, hand hygiene compliance.

Hand hygiene compliance.

Monitoring and ensuring compliance wi

th the simple yet extremely effective measure of hand sanitization, the same which has made Chile’s flu season disappear and has been documented for centuries to prevent spreading of germs, is ignored by hospitals. But why? According to the article Hand Hygiene in the Post-COVID-19 Era in Infectioncontroltoday.com it is a lack of budget resources. Infection prevention departments in hospitals are the most under-financed departments in hospitals today. Their only resource is manpower and often 3 Infection Prevention (IP) nurses that must cover an entire 500-bed hospital. A seemingly impossible task.

One of the biggest barriers for infection prevention programs to adopt electronic monitoring is said by the article to be the cost associated with establishing and sustaining these programs.

“Often infection prevention does not have a budget, and the costs can be substantial, therefore the approval to spend the funds must be made from the top leadership of the organization. Infection Preventionists can help make the business case for these programs, focusing on where other organizations have seen success and published results, use those numbers to get an idea of the changes that could happen and try to equate that to HAIs prevented and potential cost savings for the organization”.

But I disagree. Yes, the cost of these systems was once substantial, but today an entire 25-bed ward can be implemented for as little as €4,500. This implementation will provide the ward with actual hand hygiene compliance data, which can be shared with management and used to help attract more resources when problems have been documented. The installation can even be moved to new wards as preferred and therefore a hospital does not need to buy systems for all wards but can rely on sets to be moved to new wards every 6 months once sufficient data has been reached. Meanwhile the hospital can implement improvement measures and return the system 6-12 months later to measure the impact on the effort.

The benefits of hand hygiene monitoring greatly outweigh the investment. Such systems have proven to reduce employee sick leave, another burdensome cost in hospitals.  Perhaps most beneficial, a single patient sick with a healthcare associated infection cost the hospital an average of €2,600 over the time of their treatment. So, all that needs to be prevented is two hospital acquired infections to pay back such a system.

Clinical studies and validations of Sani nudge show that hospitals can achieve significant improvements across every hand hygiene situation in their facilities.

I really hope that hospitals will begin to prioritize hand hygiene in hospitals as much as society does.  In order to do this hospitals and medical facilities need to prioritize their need for compliance data, to avoid making it an impossible task. They need to invest in a solution that betters the safety of their employees and patients, and they need to champion the importance of hand hygiene in a way that suits the betterment of all society.

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