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What can we learn from secondary care about hand hygiene?

Good hand hygiene saves lives and helps reduce the strain on the NHS caused by health care-associated infections.

Good hand hygiene saves lives and helps reduce the strain on the NHS caused by health care-associated infections. Guidance from NICE says all young people should be taught the importance of hand washing to reduce the spread of disease. With an estimated eight out of 10 infectious diseases spread by touch, educating the general public is indeed crucial.

Yet having recently seen poor hand hygiene from doctors, nurses, pharmacists and assistants in a local hospital, I was reminded of the need for vigilance and properly enforced systems in all our hospitals. If we expect good hand hygiene from the public, we must ensure those on the front-line lead the way.

Sitting at my mother’s bedside in a casualty department, I saw her health put seriously at risk as a result of poor hand hygiene. This wasn’t of course by any means intentional but through a combination of work pressures and general forgetfulness.

A junior doctor for example, had varnished false nails and was also wearing a wristwatch and long sleeves, even though the requirement for doctors to be ‘bare below the elbows’ is now standard in training. Failure to roll up sleeves and wearing a watch can carry organisms from one patient to another, but despite this, and the fact she had a cold, at no point did the doctor use alcohol handrub.

As a professional in infection prevention, I desperately wanted to intervene, yet my mother was adamant that I should be quiet and ‘let them get on with their job’. If we all accept poor practice we are complicit in allowing it to continue – so I did finally say something discreetly to the  consultant, but then felt guilty that I might have got her in trouble.

On the wards I watched as busy pharmacists, nurses, health care assistants and doctors all carried out their work, however few paused to use the alcohol handrub at the end of every bed. Our healthcare workers largely do brilliant work in demanding environments, but there should be no reason not to practice proper hand hygiene, which is simple and quick.

Alcohol handrub is available widely and should be used by those caring for patients. It can swiftly be applied and staff can carry on conversations with patients while cleaning their hands. Whether it’s a consultant, nurse, pharmacist or physio, every person approaching an individual they are caring for should ensure they have first cleaned their hands with alcohol handrub. It is also vital that hospital staff touching drips or any other device that goes inside the body clean their hands first – even if they have been wearing gloves.

Raising awareness of hand hygiene is crucial, and at the Infection Prevention Society we help other healthcare staff develop their skills and knowledge in infection prevention to protect patients. If you have concerns about hand hygiene in a hospital you are visiting and you don’t want to approach staff directly, you could contact their infection prevention and control team. But please don’t be afraid to speak out; clean hands save lives.