You can lead healthcare workers to water but you can’t make them wash their hands. According to reports from the World Health Organization (WHO), hand washing compliance rates in healthcare facilities are less than 48 percent. This means healthcare workers fail to wash their hands in more than half of interactions with patients. 

“People often don’t wash their hands properly even though all the tools are there,” says Ronald Lewis of Dial Professional, Scottsdale, Ariz.

This fact poses a potentially dangerous threat, especially in healthcare settings where approximately one in 20 patients acquires an infection related to hospital care. These infections cost the U.S. healthcare system billions of dollars and cause nearly 100,000 deaths each year.

In an effort to improve compliance, the Centers for Disease Control and Prevention (CDC) introduced hand hygiene guidelines in 2002, as did the World Health Organization in 2009. Healthcare settings have also gone to great lengths to ensure employees perform this essential task. 

Besides catchphrases such as “Gel in, gel out” to remind workers to wash and sanitize hands, hospitals are monitoring hand washing habits by video and direct observation, designating hand washing coaches to train employees on proper hand hygiene, and even offering pay incentives to encourage hand washing. 

Now, jan/san distributors can help some healthcare facilities look to technology as a means of monitoring and improving hand hygiene among employees. 


Hospitals Report Inflated Hand Washing Rates

“Hand hygiene as it stands today is primarily monitored by one gold standard, and that gold standard is direct observation,” says Jeff Hall, compliance program director-North America at GOJO Industries Inc., Akron, Ohio. 

The problem with direct observation lies in what’s known as the Hawthorne Effect, a phenomenon where workers improve or modify their behavior when they know they’re being watched. When someone stands in a restroom or patient room observing and taking notes, the healthcare worker who normally doesn’t wash his hands will wash as long and as carefully as required to make a good impression. 

While this phenomenon raises compliance in the short-term, Hall cautions that it is impossible to watch everyone all the time. 

“What happens is it actually over-inflates the hospital’s reported hand washing rate, by more than 30 percent, so hospitals are reporting 85 and 95 percent compliance when it’s actually far lower,” he says.           

In fact, a study by the University of Iowa estimated that less than 4 percent of all hand hygiene activity is actually captured by direct observation. 

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Hand Hygiene Monitoring and Surveillance Systems