24 March 2015

Should patients remind health workers to wash their hands?

Hand hygiene is regarded as the most effective measure for preventing the spread of infection in health-care settings, and authorities recommend patient participation to improve hand washing.

Most patients are willing to remind health care workers to wash their hands while in the hospital, suggests a new study from South Korea.

Patient participation

But many doctors and nurses don't like the idea of patients telling them to clean up, the authors say.

"Hand hygiene is regarded as the most effective measure for preventing the spread of infection in health-care settings," the authors write in the American Journal of Infection Control. "It is of primary importance to build a better understanding and to promote a facilitating environment for patient participation among patients and health care workers."

Read: How often do you hand-wash?

Healthcare authorities already recommend patient participation to improve hand hygiene, but the authors said it's unclear whether the idea is acceptable to either patients or health workers.

Dr. Min-Kyung Kim of the Seoul National University College of Medicine and colleagues surveyed 334 patients or family members, as well as 152 doctors and 387 nurses at one hospital in Seoul.

They asked patients and families if they were aware of the importance of hand washing, if they wanted to or planned on asking health care workers about hand hygiene and why they wouldn't want to ask about it.

The researchers also asked doctors and nurses for their perceptions of the importance of hand hygiene, how often they washed their hands and reasons they didn't, and how they felt about patient participation.

Negative effects on relationships

Seventy-five percent of patients and 84 percent of their families wished to ask health care workers to wash their hands if they had not already washed them.

But only 26 percent of doctors and 31 percent of nurses supported the idea that patients should ask them to wash their hands. The most common reason they disagreed with patient participation was concern about negative effects on relationships with patients.

Other reasons included an increase in workload, patients' lack of knowledge, concerns about legal problems and concern that their authority would be undermined.

Read: Anaesthesiologists need to improve hand hygiene

If patients were going to participate, then doctors and nurses would prefer to be asked directly to wash their hands. But patients and their families preferred to assess healthcare workers' hand washing when they were discharged or periodically during their hospital stay, rather than asking health workers directly.

Dr. Nasia Safdar, who was not involved in the study, said that patients and providers agree hand hygiene is important, but they disagree on the best way to promote it.

"Patient involvement and perceptions, as well as those of providers, are very culturally specific, so findings in one setting are not necessarily generalisable," Safdar told Reuters Health in an email.

Safdar, a researcher at the University of Wisconsin Department of Medicine, said she believes both doctors and patients would feel comfortable if the patients had the option of reminding staff to wash their hands.

Hand washing is "critical for the prevention of infection," she added.

SOURCE: American Journal of Infection Control, online March 6, 2015.

Read more:

Only 1 in 20 washes hands properly

Beat germs

SA lags behind best disease barrier

Image: Doctor washing hands from Shutterstock


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