Your staff may be falling down on both hand hygiene and safe-injection recommendations a third or more of the time, regardless of whether you have carefully crafted policies and adequate supplies in place, a new study suggests.
The study, based on observations by medical students at 15 geographically dispersed facilities in New Mexico, found that although the facilities had recommended policies and practices in place in 93% of all cases, as well as adequate supplies, staff members failed to wash their hands 37% of the time, and complied with all recommended injection-safety elements only 66% of the time. The study appears in the April issue of the American Journal of Infection Control.
Medical assistants (52%) were most likely to miss hand hygiene opportunities, followed by physicians (39%) and nurses (25%). The most common shortcomings with injection practices were failure to disinfect vial rubber septums with alcohol (22%), hand hygiene failures (18%) and failure to date multi-dose vials upon opening (7%).
The authors note that "there can be both real and perceived barriers to hand hygiene, (including) concerns about skin irritation, interference with worker—patient relationship, wearing gloves, high workload, and understaffing." Possible solutions, they say, include "locating alcohol handrub dispensers inside and outside of every exam room door, availability of alcohol handrub, which tends to be less irritating than soap and water, (and) availability of free skin care lotion."
In general, the findings "highlight the need for ongoing quality improvement initiatives," they conclude, and underscore the importance of observational audits.