Good or bad, habits happen without too much thinking. Like handwashing (a very good habit). Hopefully it’s an automatic response after using the washroom or before preparing food. But what about other situations, like after you’ve touched a doorknob or shaken someone’s hand, especially if you’re in a hurry? Do you remember to wash your hands every time, or would it be helpful to be reminded?
In the health care setting with vulnerable patients, those habits become critical and are an expected part of the care process. Hand washing needs to happen at key stages to reduce the risk of transmission of infection. The reality is that compliance rates among North American health care professionals can range from as high as 87% to as low as 30%. And while it’s easy to assume that laziness may be at the root of far from perfect compliance, Sunnybrook senior scientist Dr. Donald Redelmeier co-authored a very interesting viewpoint entitled “Why even good physicians do not wash their hands.”
The article explores behavioural research on possible contributing factors. For example, because bacteria are invisible and can’t be seen on the hands, the good habit of handwashing “receives little reinforcement, involves årecurring inconvenience and produces little feeling of accomplishment.” The article sites that most handwashing opportunities are placed at a patient’s room entrance. While this might seem logical, the authors write that this is the exact time when a doctor’s attention is focused on a new patient interaction and an often serious and stressful health situations. Handwashing is also not glamorous, they write. “Physicians might pursue reputations for having great acumen, technical skill, bedside manner – but they are unlikely to pride themselves for a hand hygiene award.” It’s a fascinating read and I encourage you to take a few minutes to read the article in its entirety.
So what’s the answer? There is likely no one solution, but the article suggests that it may be helpful in some situations to involve patients and family members in supporting the cause, and reminding everyone about the importance of good hand hygiene. A new initiative that’s part of ongoing awareness campaigns at Sunnybrook is doing just that. Called ‘Clean Hands Matter’, the campaign involves placing friendly reminder information about best practices in hand hygiene at the bedside. Patients and their family members can ask their care team: “Have you cleaned your hands?” Some care teams wear buttons to facilitate the question. It’s not about offending or undermining, but rather about being there for patients.
So how comfortable would you be as a patient asking your healthcare provider to wash their hands? The reality is not everyone will, but some might. This tool is there as a message of empowerment to patients. It also stands up as a consistent reminder to practice good hand hygiene. It’s harder to overlook the message if it’s all around you, after all!
