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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Blind Spot: Many Hospitalized Patients Not Encouraged to Wash Hands

By Gary Evans, Medical Writer

Although it is recommended by the Centers for Disease Control and Prevention (CDC), hand washing by hospitalized patients has not been widely emphasized. Like everything else, that is subject to change in the ongoing COVID-19 pandemic.

Patients generally understand and sometimes encourage hand hygiene by healthcare workers, but they are not likely to find alcohol hand rubs at their bedside for personal use. This is counterintuitive, as it is clearly established that patients can contaminate their own invasive lines and self-inoculate infections.

“We know from data from all over the world that patients’ hand hygiene practice is very poor,” says Shanina C. Knighton, PhD, RN, an instructor and researcher at Case Western Reserve University in Cleveland, OH. “Patients’ hand hygiene is even lower than some of the worst healthcare compliers — less than 40% at times.”

A longstanding concern is that impaired patients and those with dementia may try to consume or otherwise misuse alcohol hand rubs.

“Right, but we’re not talking about all patients,” says Knighton, who recently authored a study on the issue. “The United States has about 150 million admissions each year. How many of those are people who can adequately clean their hands?"

The CDC recommends that hospital patients wash their hands for their own protection, but hospitals are not required to provide information to patients about cleaning their hands, she notes.

“As a patient in a healthcare setting, you are at risk of getting an infection while you are being treated for something else,” the CDC states. “Patients and their loved ones can play a role in asking and reminding healthcare providers to clean their hands. Your hands can spread germs too, so protect yourself by cleaning your hands often.”

The CDC recommends patients wash their hands at regular intervals, including:

  • before preparing or eating food;
  • before touching their eyes, nose, or mouth;
  • before and after changing wound dressings or bandages;
  • after using the restroom;
  • after blowing their nose, coughing, or sneezing;
  • after touching hospital surfaces, such as bed rails, bedside tables, doorknobs, remote controls, or the phone.