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Study finds specific factors affect hand hygiene in ED

Thursday October 6, 2011
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Researchers studying hand hygiene of healthcare workers in the ED found certain care situations, including bed location and the type of healthcare worker performing care, resulted in poorer hand hygiene practice.

"We found that receiving care in a hallway bed was the strongest predictor of your healthcare providers not washing their hands," said Arjun Venkatesh, MD, an emergency medicine resident at Brigham and Women's Hospital in Boston and author of the study. Venkatesh said this finding can focus attention on infectious risks created by the national trend of ED crowding.

The study, which the researchers said is the largest to date to evaluate hand hygiene in an ED, 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, perhaps because these workers receive less training in hand hygiene procedures than other workers.

The researchers collected data on over 5,800 patient encounters in the ED. Overall, appropriate hand washing practices were used 90% of the time.

The authors hope the study will lay the foundation for future research and quality improvements in understanding the role of the ED 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," said Jeremiah Schuur, MD, MHS, director for quality, safety and performance improvement for the Department of Emergency Medicine at Brigham and Women's.

The study appears in the November issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America. To access the study via subscription or purchase, visit http://www.jstor.org/pss/10.1086/662374.


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