The Constant Struggle? Hand Hygiene

By MedlineClinical Solutions, Hot TopicsLeave a Comment


To celebrate World Hand Hygiene Day and bring awareness to the struggles surrounding the key ties between hand hygiene compliance, infection prevention and skin health, we turn to our experts for insights. Medline interviewed a select few of industry experts to explore the topic further and to hear their stories, ideas and visions for success in better compliance.

Q: In your eyes, what is the biggest struggle clinicians have with hand hygiene compliance?

Kati Kleber, RN, BSN, Neurosciences Intensive Care Unit Staff Nurse. The biggest struggle is just the high volume of hang hygiene necessary in a 12-hour shift.  You touch so many patients over and over again, walk in and out of so many rooms, and wear so many pairs of gloves.

Martie L. Moore, RN, BSN, MAOM, CPHQ, Chief Nursing Officer, Medline Industries. The word compliance might be a contributing factor. Engaging innovative solutions to ease the way of the providers so they can do hand hygiene in a manner that does not take effort on their part is one solution.

Beth Boynton RN, MS-Independent OD Consultant and Author.  Having the resources necessary to comply.

Q: What do you feel is the number one cause for hand hygiene compliance rates to remain very low?

Amin Setoodeh, RN, BS, BSN, Vice President Clinical Services, Medline Industries. Time! Healthcare providers are under tremendous pressure due to lack of resources, shortage of staff and higher acuity of illness.

Kati Kleber. I think that because you can’t physically see the germs, bacteria being transmitted, you can forget about the significant harm that can occur.  You don’t think it’s such a big deal because you can’t physically see something negative happen because of your negligence.  It happens down the line, not instantly.  So if a negative outcome occurs, you can’t pinpoint it to a specific person not performing appropriate hand hygiene. 

Martie L. Moore. Not having the tools at their disposable – Tools to protect hands, tools to help hands, tools to clean hands.  The tools have to be easy to access, easy to use.  Study the patterns of care and then design the tools for hand hygiene to be there at the right time.

Q: Quite a few clinicians on social media mentioned the use of gloves when “unnecessary” could offend the patient. One clinician even mentioned in the past never having to wear gloves unless handling sterile procedures, and that the required usage of gloves is hard to follow and remember. How can these viewpoints and practices hinder hand hygiene compliance and nurse-patient safety?

Amin Setoodeh. Studies and clinical data prove how important it is for us, the healthcare community to embrace the hand hygiene compliance. I believe a heightened awareness on the impact of good hand hygiene on quality of life must be practiced on a consistent basis in every system.

Kati Kleber. Those are horribly unsafe practices!  I am very unapologetic about needing gloves to touch contaminated items or patients.  It’s all business to me – and the business is their safety and well-being, so I am very matter of fact and not personal about always wearing gloves.

Martie L. Moore. That is rare thinking these days. Gloves have become a safety barrier for both the patients but also the care providers.

Q: What is one way administration can make compliance training and education more fun and relatable to the clinician?

Beth Boynton. Engage them. Ask clinicians what they need in order to comply, what barriers they face and what ideas they have. 

Amin Setoodeh. Provide some facts to the staff about the impact of compliance on quality of life. People want to contribute and be part of something special so why not share the results with the team and encourage better outcomes on a consistent basis.

Kati Kleber. A commitment from the physicians as a facility would go a long way with the nursing staff.  Giveaways with really good hand lotion would be awesome.

Q: Where will hand hygiene compliance need to be in the next few years to prompt better outcomes for the nurse and patient?

Amin Setoodeh. I truly believe we need to increase the national bench marks for hand hygiene and develop parameters for offering financial incentive to systems to improve compliance.

Kati Kleber.  I think more of a focus needs to be on the patient performing hand hygiene themselves. We focus so much on the staff, but the patients need to wash their hands as well.

Martie L. Moore. The reality is that we are dealing with human beings who have failure rates because of their humanness.  We get busy; we rush into a room because someone is trying to get out of bed.  Systems have to be developed that enhance the ability of the nurse to practice best practices of hand hygiene.

Q: How important is it for facilities to pay closer attention to any increased incidences of dermatitis?

Beth Boynton. Extremely. As compliance increases, it is likely that dermatitis will, too.  Preventing negative impact of compliance on clinicians will help ensure compliance, as well as demonstrate respect for the work and workers.

Amin Setoodeh. It’s extremely important, since it may be highlighting one of the challenges the staff is facing while promoting good hygiene, which can become an obstacle in achieving better compliance.

Martie L. Moore. Absolutely critical.  Cracked, dry, hurting hands make it even more difficult to practice best practices when it comes to hand hygiene.

Q: Hand hygiene compliance and skin care should go together, but oftentimes do not. Why do you think there is a disconnect?

Amin Setoodeh. I believe it’s due to lack of awareness on this topic. The right approach would include a macro discussion by exploring all specific contributing factors in every clinical setting and by looking at topics such as skin care.

Beth Boynton. Clinicians are often more focused on taking care of others as opposed to themselves. Both are necessary, and healthcare leaders can play an important role in encouraging this mindset.

Martie L. Moore. I have never heard organizations reviewing compliance of maintaining skin health.  Maybe a new approach would be to speak to healthy skin, healthy hands and healthy patients. Maybe it is time to challenge all of us on best practices for healthy hands.

Perhaps our experts are on to something here…

Let’s make 2015 a record-breaking year for hand hygiene compliance rates. Medline challenges all clinicians and leaders to better communicate the struggles and the solutions that will help create and maintain happy, healthy hands, patients and healthcare professionals.

Clinicians, it’s time to start caring for yourself, not just for your patients, and to win the battle against dry, irritated hands yet still comply with hand hygiene protocols. How to master it all? Let us introduce you to the ultimate hand care challenge.

Share your thoughts: How can facilities pave the way for better hand hygiene compliance rates?

About the Author


As a manufacturer and distributor of healthcare products and solutions, Medline helps drive both clinical and financial success. We do that through a personalized approach to understand our customers’ needs in an environment that demands lower costs and better outcomes. Our commitment to advancing healthcare is evident in our actions every day.

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