FAST FOREWARD Airing out dirty hands
On Cinco de Mayo, the day that this “Fast Foreward” column was written, the healthcare industry was “celebrating” World Hand Hygiene Day with the launch of the Centers for Disease Control and Prevention’s new “Clean Hands Count” campaign. At the Premier Safety Institute, veteran safety advocate Gina Pugliese RN, promoted this clever and creative campaign to remind
all of us about something so fundamental, so basic. “The science is clear: Clean hands protect patients from life-threatening infections!” Pugliese wrote in her “SafetyShare” newsletter. But if you continue reading her col- umn, you’ll fi nd some disturbing nuggets to give us pause.
“Dirty hands are a contributing factor in the spread of healthcare-associated infections that affect 1 in 25 hospital patients on any given day,” she wrote. Apparently, a 4 percent ratio is not alarming enough to cause behavioral change.
“Despite the success in achieving 100 percent compliance with hand hygiene in many
healthcare organizations,” she continued, “studies show that some healthcare providers perform hand hygiene less than half the time they should. So our work is not done yet.” No, it’s not. Shame on us.
Despite the detailed research, reporting and presentations by noted and well-respected infection prevention expert Elaine Larson, PhD, RN, FAAN, CIC, going back two decades at least, and the continuing campaigns of federal, state and local agencies and providers and suppliers, clearly the message is not resonating. In fact, the message is fi ne. We have all the data and justifi cation we need — clinical, fi nancial, operational.
We just need to act and change our behavior. Surely as infection preventionists assemble in Charlotte this month for the Association
for Professionals in Infection Control and Epidemiology (APIC) annual meeting, this issue continues to hover as a sore spot that they struggle to enforce.
Education and information can work, so long as both are understood and heeded. So
far, many seem to “get it,” but they largely don’t comply, tacitly rejecting it with a variety of excuses, such as daily distractions and duties to downright forgetfulness. Nonsense. This is one area where experts — such as Larsen and Pugliese and countless
others — have connected the dots and demonstrated cause and effect. To ignore that is nothing short of stupidity. Ultimately, we all suffer.
Federal regulators and public and private payers have refused to penalize lax hand- washing practices by denying reimbursement. Unfortunately, among those “Never Events” they target, the link to hand-washing defi ciencies remains fuzzy at best. We have access to a variety of tracking mechanisms that slam up against privacy issues and IT connectivity concerns, among others. Anti-shaming attitudes and bandwidth bias trump unnecessary exposure to micro-organisms that can harm and kill us. It’s high time to change direction and discourse. The only logical solution? The air around us. Obviously, even the most intelligent experts and the most creative educational campaigns won’t motivate us to change our behavior, and compensatory and punitive actions won’t be accepted or tolerated either.
We need something ubiquitous: A device that emits a form of light, sound or aspirated chemical compound that’s safe to breathe in or touch our skin but absolutely lethal to the micro-organisms that can hurt us. This device can be affi xed to doorframes, on ceilings and walls, in vents or maybe even worn on your body. Just like high-tech real-time loca- tion system technology, they’d always be on, always doing what we apparently refuse to do — clean us as we seem to be so incapable of cleaning ourselves. This device would be different than those room decontamination “robots” that emit pulsed light beams to kill microbes but cannot make contact with or be in proximity to humans. While we have the scientifi c and technological know-how to create such a device, how- ever, we most likely would be sending the wrong message by “legalizing,” if not rationalizing, poor hygiene habits. Perhaps it’s a Catch-22 situation, but we’re all catching bugs for it instead of killing them.
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