Hand hygiene important to ensure patient safety

Hand hygiene may seem to be a simple act. But such simple act can mean a lot for patient safety.

That is what Prof. Didier Pittet, MD,  director of Infection Control program and the World Health Organization Collaborating Center on Patient Safety, University of Geneva Hospitals,  said during the national symposium on hand hygiene and patient safety last Jan. 14.

Speaking before the participating chiefs of hospitals, infection control heads and infection control nurses from select hospitals in the country at the Enrique Ona auditorium, National Kidney and Transplant Institute, Quezon City, Pittet pointed out that compliance of hospital staff to basic hand hygiene protocols is the key in preventing healthcare-associated infections (HCAI).

Pittet, a world-renowned expert on HCAIs, pioneered the Geneva hand hygiene model, a “multimodal strategy based on education, recognition of opportunities for hand hygiene, and feedback performance.” He also led the development of the “Five Moments” concept, which explained to healthcare workers the critical moments when hand hygiene must be carried out.

Organized by the Department of Health (DOH) and the Aesculap Academy, the symposium provided the participants with a comprehensive overview of the new WHO Guidelines on Hand Hygiene in Healthcare and information on the available tools and resources for its effective implementation. It is expected to raise awareness, mobilize people and all stakeholders and provide technical guidelines.

HCAI menace

HCAIs, or “nosocomial” and “hospital” infections, affect patients in a hospital or other health-care facility, and are not present or incubating at the time of admission. They also include infections acquired by patients in the hospital or facility but appearing after discharge, and occupational infections among staff. According to the WHO, hundreds of millions of patients are affected by HCAIs worldwide each year, leading to significant mortality and financial losses for health systems

Despite the fact that strict hand hygiene remains the gold standard for reducing HCAI, studies show that hospital staff’s compliance with protocols like cleansing with soap and water or alcohol-based gels is around 50 percent.

At any time, over 1.4 million people worldwide suffer from infectious complications acquired while hospitalized being treated for a medical condition, according to the WHO. The risk of HCAI in developing countries is from two to 20 times higher than in developed countries. In some developing countries, the proportion of patients affected by HCAIs can exceed 25 percent, according to the WHO.

Global studies show that compliance to the guidelines resulted in the reduction of healthcare-associated infections. Hospital management is vital in implementing the system change and sustaining an institutional safety climate.

Pittet said hand hygiene is key to ensure patient safety and prevent the further spread of diseases, especially now that cases of measles, a virus-caused infection of the respiratory system, have been on the rise. Recently, the Inquirer reported Health Assistant Secretary Eric Tayag as saying that from Jan. 1 to Dec. 14, 2013, there were already 1,724 confirmed measles cases nationwide, 21 of which led to death. The National Capital Region had the most number of cases with 744.

Meanwhile, DOH said it is working on ways to combat cases of HCAIs in the hospitals.  Health Undersecretary Teodoro Herbosa said that to achieve quality care, hospitals should set the standards to be implemented strictly and a body should be formed to monitor the implementation.

Infection control

There is a need for an infection control program, Herbosa said, to take on emerging infections/threat of pandemic, increasing resistance of pathogens, and the increasing cost of healthcare. This program, he said, will “plan, review and approve yearly program; ensure adequate resources and appropriate [hospital] staff, and review risks.”

According to Herbosa, these are the department’s “seven steps to patient safety”:

1. Build a “safety culture,” a culture that is open and fair.

2. Lead and support the hospital staff by establishing a clear and strong focus on patient safety.

3. Integrate risk management activity by developing systems and processes to identify and manage risks.

4. Encourage staff to report incidents.

5. Involve and communicate with patients and the public.

6. Learn and share safety lessons by encouraging staff to analyze how and why incidents happen.

7. Implement solutions to prevent future incidents by changing the practice, process, or system.