Hospital Staff Wash Their Hands Very Often in the Presence of Auditors: Study

Healthcare workers and hospital staff diligently maintain hand hygiene in the presence of auditors and quality inspectors, finds a study.

Experts from the Infection Prevention and Control at the University of Health Network and the University of Toronto observed the hand hygiene and cleanliness regimes of healthcare workers in the presence of auditors in hospitals. They employed the 'Hawtherone effect', a theory that suggests workers tend to work better and modify their behavior and conduct when they know their actions are being observed.

 The study electronically monitored hand washing habits of 60 healthcare workers by installing ultrasound tags on soap dispensers. Each time an individual would press the button on the soap dispenser to wash hands; it would automatically get recorded in a central data base. In addition, the experts also assigned certain number of people to walk around hospital premises wearing white lab coats as auditors.

Both auditors and subjects were not informed about the aim of the trial. After conducting 12 electronic audits on hand wash, the experts found a three times increase in number of hand washes per hour by healthcare staff when an auditor was visible. The hand hygiene rate reduced to 1.48 times for every hour when the auditors were not present around the staff members.

"The difference in hand hygiene rates, when an auditor is present compared to those times when one is not, is huge in this study, and we showed this effect to be very consistent," said Michael Gardam, study author and director at the Infection Prevention and Control, in a press release.

"The magnitude of what we found calls into question the accuracy of directly observed hand hygiene rates and the usefulness of measuring and reporting them. That said, human auditing of hand hygiene has been helpful to draw attention to this important preventative measure we just can't stop focusing on it because our posted rates are not nearly as high as we think they are," he adds.

The authors believe this method promotes hand hygiene and health of hospital staff that are likely to contract infections and diseases while working. Reminding people again and again to wash hands is often viewed as 'nagging' and discourages their hygienic and healthy habits.

More information is available online in BMJ Quality and Safety Journal.