Add patients to your hand-hygiene team

Have you washed your hands?’

Empowering patients by educating them to ask their caregivers to wash their hands can dramatically improve compliance, an infection control professional reported recently in Washington, DC, at the annual meeting of the Society for Healthcare Epidemiology of America.1

"A big part of the behavioral intervention is for the health care worker to see something everyday," said Maryanne McGuckin, RN, infection control professional at the University of Pennsylvania in Philadelphia. "The patient is the intervention everyday. They never go away, whereas [ICPs] go away along with our lectures and programs."

McGuckin and colleagues evaluated the effect of a patient hand-hygiene education program called "Partners in Your Care" on staff compliance with hand washing in a 24-bed inpatient rehabilitation unit.

Sixty-six patients were enrolled in the intervention phase of the study after agreeing to ask all health care workers who had direct contact with them, "Did you wash your hands?" Compliance with the program was measured through soap usage per resident day before, during, and after the intervention. Patient assessment of the program was determined by a discharge survey.

The program increased hand-hygiene compliance by 56%. That was sustained for three months post-intervention by 40%. This program empowers patients with responsibility for their own care and provides on going hand-hygiene education, she emphasized. Overall, 65% patients surveyed said they asked the nurse, but only 35% asked a physician. About half of the patients said they were comfortable asking the question, and 60% of workers said they washed their hands when asked by the patient. Trinkets, stickers, and other materials were used to let shy patients get the message out without asking the worker, she added.

"I think patients are ready to be part of our hand-hygiene team," she said, noting that workers only rarely resent the question. "What usually happens within two weeks is that the health care worker walks in the room and says, Isn’t there something you are supposed to ask me?’ It’s amazing how it is such a subtle way to get people to do something we have trying to get them to do [forever]."


1. McGuckin M, Taylor A, Martin V, et al. Evaluation of a patient empowering model for increasing hand-washing compliance on an inpatient rehabilitation unit. Abstract 244. Presented at the annual meeting of the Society for Healthcare Epidemiology of America. Washington, DC; April 2003.