Visit hospital early in the morning to ensure medics have clean hands

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A study has warned that nurses and doctors wash their hands less often the longer they are on shift. This results in an increased risk of spreading infections among patients.

Researchers found that the demands on carers and medics working long shifts drained their mental ability and this led to them refraining from washing their hands as often as they should.

The latest figures from the National Institute for Health and Care Excellence (NICE) indicate that despite the strict guidelines to prevent bugs spreading, one in 16 people treated in NHS hospitals becomes infected.

The University of Pennsylvania’s Hengchen Dai, said that in the same way repeated muscle exercise leads to physical fatigue, repeated use of resources results in a decline in a person’s self-regulatory ability. Dai stated that demanding jobs are able to energise employees, however the pressure they are placed under results in them placing more focus on the maintenance of their primary tasks, for example, medication distribution or patient assessment, especially when they are tired.

Dai said that for hospital staff, washing their hands may be considered a lower-priority task, thus this task appears to suffer as the workday progresses.

Mr Dai and his research tem assessed three years of hand-washing data from 4157 healthcare workers in 35 US hospitals. The sample was made up of 65% nurses, 12% nursing assistants, 7% therapists, 4% doctors and the balance were other hospital workers.

It discovered that compliance with rules on hand-washing declined by an average of 8.7% during a 12-hour shift. However, it found that if there were longer breaks during the shift, hand-washing guidelines were adhered to when staff returned to their duties.

A previous study done in Switzerland indicated that hand-washing in hospitals can result in a reduction of infections of 3.9 per 1000 patients. Another study indicated that the cost per patient suffering with a healthcare-acquired infection is about £12966.

By making use of the data, the researchers calculated that there would be an extra 600000 infections annually, at a cost of around £12.5bn per year to US hospitals.

NHS guidelines stipulate that clinical staff should clean their hands thoroughly, either by using an alcohol-based handrub or with soap and water, immediately prior to and immediately after making contact with a patient, even if they are wearing gloves.

According to NICE, hand hygiene in NHS hospitals has seen a dramatic improvement in recent years, however good practice has still not been achieved everywhere.

Dr Katherine Milkman, a co-researcher, said this is the first study which has investigated the effects of work demands on rule compliance over a single workday, as opposed to over several weeks, months or even years.

She said they believe this line of research may be applied to other forms of workplace compliance, such as manufacturing safety standards, safety driving in trucking and banking ethical standards.

Image Credit: Sean Winters

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