Patient Empowerment Tool Improves Handwashing Despite Physician Opposition
August 17th, 2017
Physicians might not have been happy hearing constant reminders to wash their hands, but a new initiative improved their hand hygiene compliance rates anyway, according to a recent report.
The report was based on the results of multidisciplinary research led by Allison Lastinger, MD, at the West Virginia University (WVU) School of Medicine. The team conduced a cross-sectional survey of parents of hospitalized children, adult patients, and primary care physicians at the facility’s J.W. Ruby Memorial Hospital, a 645-bed tertiary care teaching hospital in Morgantown.
The researchers employed an anonymous, self-administered questionnaire to gauge attitudes about a new patient empowerment tool (PET) at the hospital. Parent and patient surveys were distributed from December 2015 to June 2016, while the physician survey was administered in November 2015. A total of 108 adult patients and 114 parents completed the first survey.
Results indicated that 64% of adult patients and 70% of parents increased their sense of control of medical care. Generally, the patients and parents said they were comfortable using the PET to remind healthcare workers to perform hand hygiene: 77% of parents said that was true for physicians and 81.4% for nurses, while 64.8% of adult patients agreed with that statement for physicians and 71.2% for nurses.
Interestingly, parents were nearly 20% more likely than adult patients to speak up if a physician did not clean their hands.
As a result of PET and other measures, hand hygiene rates at the hospital increased from 48% in 2015 to about 75% in 2016.
"Forty-eight percent is pretty standard, so 75% is phenomenal,” Lastinger explained
The reviews were not as positive among 89 healthcare provider responses (29 residents and 60 attending physicians). Only 54.9% said they believed patients should be involved in reminding providers to perform hand hygiene. They also indicated that it would be better if patients made that request verbally rather than using the PET to remind them.
Meanwhile, of the physicians who did not support patient involvement, 37% said it was not the patient's responsibility to remind physicians to perform hand hygiene; 16% suggested it was embarrassing to the doctor; and 13% expressed fear it would negatively affect the patient-physician relationship.
"Based on the results of this study, patient empowerment appears to be an effective strategy to facilitate healthcare workers' adherence to hand hygiene, but acceptance of the PET by providers remains a challenge," Lastinger emphasized. "Barriers to hand hygiene adherence among healthcare providers should be identified and addressed."
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