Study Reports Predictors of Poor Hand Hygiene in an Emergency Department

Researchers studying hand hygiene of healthcare workers in the emergency department found certain care situations, including bed location and type of healthcare worker performing care, resulted in poorer hand hygiene practice. The study was reported in the November issue of Infection Control and Hospital Epidemiology.

"We found that receiving care in a hallway bed was the strongest predictor of your healthcare providers not washing their hands," says Dr. Arjun Venkatesh, an emergency medicine resident at Brigham and Womens hospital in Boston, and author of the study. Venkatesh believes this finding will focus attention on infectious risks that are created by the national trend of emergency department crowding.

The study, which is the largest to date to evaluate hand hygiene in an emergency department, confirmed many known contributors of poor hand washing practices. For example, the researchers observed providers wearing gloves during patient care instead of washing their hands, an inappropriate substitution for infection control purposes.

The study also found that workers who transport patients between hospital departments and rooms were less likely to wash their hands compared to other healthcare workers. This may be because these workers receive less training in hand hygiene procedures than other workers.

The researchers collected data on more than 5,800 patient encounters in the emergency department. Overall, appropriate handwashing practices were used 90 percent of the time.

The authors hope the study will lay the foundation for future research and quality improvements in understanding the role of the emergency department in healthcare associated infections.

"With nearly one in five U.S. residents visiting an emergency department each year, and emergency departments serving as a frequent interface between the public and patients with communicable diseases, we have to build systems that ensure the highest standards of hand washing and infection control to ensure the safest care for all patients," says Dr. Jeremiah Schuur, director for quality, safety and performance improvement for the Department of Emergency Medicine, Brigham and Womens Hospital.