One in four district health boards are not meeting the national standard for hand hygiene. Photo / 123RF
One in four district health boards are not meeting the national standard for hand hygiene. Photo / 123RF
Hospital staff failing to wash their hands are putting patients at risk of serious infection, with a microbiologist warning grubby practices could accelerate the spread of deadly bugs.
The Herald can reveal that one in four district health boards are not meeting national hand-hygiene standards and emergency departments are theworst areas in hospitals for non-compliance.
Medical experts say the risk of healthcare workers not washing their hands before and after touching a patient could be life-threatening.
"Every time a health worker doesn't wash their hands, they've created an opportunity for a potentially deadly microbe to spread," said Dr Siouxsie Wiles, Associate Professor of Microbiology at the University of Auckland.
She said it was absolutely crucial staff make every effort to remove these opportunities.
Dr Siouxsie Wiles, Associate Professor of Microbiology at the University of Auckland. Photo / File
All DHBs employ auditors who observe and record hospital staff hand washing at five crucial moments including: before touching a patient, before a procedure, after a procedure or body fluid exposure risk, after touching a patient and after touching a patient's surroundings.
Three times a year the Health Quality and Safe Commission (HQSC) collects that data to see which DHBs are meeting the national target, which is an 80 per cent compliance rate.
The latest data, recording hand-hygiene compliance between April 1 and June 30, showed five DHBs were not meeting that target.
Taranaki DHB had the worst rate, reaching only 69.8 per cent. Of the 800 times hospital staff were meant to wash their hands, it was only done 558 times.
Mary Bird, Taranaki DHB's operations manager of clinical governance, said staff were disappointed in this quarter's results and were committed to achieving 80 per cent for patient safety.
Bird said hand hygiene was being prioritised as a focus area for the DHB's Infection Prevention and Control Service. It had implemented multiple strategies to improve hygiene practices, including more frequent reporting and recruiting additional auditors to ensure adequate coverage.
Hauora Tairāwhiti had the next worse compliance, with hands being washed 584 times out of 815, or 71.7 per cent. Bay of Plenty DHB was next at 76 per cent, followed by Nelson Marlborough DHB and Lakes DHB.
Julie Robinson, Bay of Plenty DHB's director of nursing, said the DHB had launched a campaign called, "Before you touch me, please clean your hands".
"This is the message on stickers patients have been encouraged to wear, challenging their healthcare professional to stop and think about hand hygiene.
"The campaign is part of a wider plan to lift our hand-hygiene rates across both hospitals, to remind staff about best practice hand hygiene whilst also empowering the patient," Robinson said.
Health Minister David Clark. Photo / File
Overall, the national hospital staff hand-washing compliance rate was 85.1 per cent, with Waitemata DHB leading the way at 89.7 per cent. This translated to staff washing their hands 12,629 times out of 14,085.
Nationally, EDs were the worst departments for hand washing, with a compliance rate of 80.1 per cent. Mental health wards had the best, achieving 93.7 per cent.
Dr Sally Roberts, clinical leader for the HQSC's infection prevention and control programme, said part of the reason for EDs' low compliance rates was the fast pace in which they operated.
Cleaners and meal staff were the healthcare workers with the lowest compliance rate at 69 per cent.
Roberts said overall rates had improved. In 2007 the national hand-washing compliance rate was about 30 per cent, compared with about 60 per cent when they started the programme in 2012.
"I remember back in the day hospital workers barely ever washed their hands but as we know it's so important," Roberts said.
There was still considerable room for improvement because it was so easy for germs to spread if healthcare workers weren't washing their hands.
"They could be treating a surgical wound that breaks the skin and then be putting a catheter up the urethra and into the bladder of another patient.
"If they are not washing their hands in between then it's highly likely those germs will transmit from one patient to another," Roberts said.
Health Minister David Clark said he was acutely aware of the importance of hand washing, particularly in a clinical environment.
"I recently visited a neonatal intensive care unit which, while dealing with our most vulnerable and precious patients, boasts one of the lowest infection rates in the country.
"Staff attributed this to the emphasis placed on proper and frequent hand washing by the unit's leader," Clark said.
He said it underlined the importance of the HQSC's Hand Hygiene NZ programme.
