Patient Safety Week

Patients' Hands Matter Too

Colin Furness


By Colin Furness, MISt, Ph.D., MPH

Director of Research and Knowledge Development at Infonaut, Inc.

This week, the Canadian Patient Safety Institute hosted Canadian Patient Safety Week, which focuses on and encourages healthcare professionals, patients, and their families to ask questions, listen to answers and talk about concerns and ways to improve patient safety. This week serves as an important reminder that patient hands also play a role in overall patient safety.

For decades, we have seen a significant focus on the importance of hand hygiene programs for healthcare workers. However, could even more be done to decrease hospital-acquired infections (HAIs)?  Might the Five Moments be usefully extended?

My colleagues and I, at Infonaut Inc. in Toronto, studied this question through a novel lens, using our real-time tracking system in a hospital to measure the movement of staff, patients, and equipment, as well as measuring the use of soap and alcohol-based hand sanitizer. We searched for patterns of behavior (besides staff hands) that could facilitate the chain of transmission. Noting that several of the most serious hospital pathogens travel by the fecal-oral route, we paid particular attention to patient bathrooms. What we saw was intriguing.

We observed 279 patients make more than 12,000 bathroom visits, and found that hand hygiene only occurred 30% of the time. When we looked at patient hand hygiene around thousands of meals, we found a similar rate at breakfast (and only marginally better at lunch and dinner). We then looked at patient hand hygiene when patients entered and left their rooms – precisely when we emphasize staff hand hygiene – and found average rates of only 5%. Down the hall, we found a 3% hand hygiene rate in the patient kitchen. All of these patients were organ transplant recipients taking immunosuppressant drugs.

The magnitude of this problem has been invisible until now, because it has not been measurable until now. So what can be done?  There is some evidence that providing hand hygiene within reach of patients in bed may dramatically improve their hand hygiene rates. And because we believe patients’ mouths are touched by their own hands more than anything else, we think that bedside hand hygiene could cause some infection rates to plummet – just as they did in the early days of the Five Moments. This research and the timing of Canadian Patient Safety Week provides hospitals with the opportunity to act on their own, and to prioritize patient hand hygiene as a serious patient safety issue. 

Learn more about the solutions GOJO provides for the healthcare industry at: gojo.com/healthcare or gojocanada.ca

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