ECJ EUROPEAN Cleaning Journal

With hand washing rates said to be astoundingly low among healthcare workers - and costs related to hospital-acquired infections soaring - some hospitals in the US have resorted to extreme methods to encourage better hygiene by their doctors and nurses.

When healthcare workers at Long Island, New York's North Shore University Hospital enter an intensive care room for example, a motion sensor is triggered. A camera is then turned on and its video footage sent to a centre in India where workers watch to ensure proper hand hygiene is taking place.

According to the New York Times studies show that rates of hand washing in hospital staff prior to any type of patient interaction are as low as 30 per cent without some form of encouragement.

The reasons for non-compliance are many. Philip Liang, who founded General Sensing, which provides sensor badges to hospital workers that track their hand washing, says an overburdened mind might be a chief reason.

"Nurses have to remember hundreds - thousands - of procedures," he told the New York Times. "It's really easy to forget the basic tasks. You're really concentrating on what's difficult, not on what's simple."

Liang's product knows when a healthcare worker has neglected to wash his or her hands. A badge vibrates when the worker approaches a patient's bed, gently reminding them to scrub up.

Studies have also found that doctors, more than nurses or any other workers, are most resistant to washing their hands. The reason, according to the studies, seems to be a resistance to authority.

To root out non-compliance and avoid losing Medicare funding under new federal rules that punish hospitals where preventable diseases are transmitted, hospitals have begun instituting an array of hand washing encouragement techniques in addition to high-tech surveillance.

They are training hand washing coaches, hiring monitors who dress like hospital personnel and secretly watch for hand washing compliance, and giving out coupons for things like pizza and coffee to those who meet certain levels of compliance.

Hand washing coaches are being trained for example, monitors who dress like hospital staff and secretly watch for hand washing compliance and giving out coupons for treats like pizza and coffee to those who meet certain levels of compliance.
Dr Brian Koll of Beth Israel Medical Center in Manhattan trains compliance coaches. One of the techniques he uses, he borrowed from football. When one worker notices another has not washed his hands, they can be given a red card by their colleagues.

Koll's hospital also has its workers wearing pins that read things like ‘Ask me if I've washed my hands,' ‘Got gel,' and ‘Hand hygiene first' and Koll said patients' families are not shy about asking doctors about their cleanliness.