Hand Hygiene - Patients Should Not Have to Remind Us to Wash Our Hands

As part of strategies to improve hand hygiene compliance and create a culture of safety, hospitals are asking patients to remind their caregivers to wash their hands or to rewash them within view.

Is this the right thing for our patients?

This puts many patients in awkward positions as patients are often in states of vulnerability and don’t want to do anything to negatively impact the caregiver/patient relationship. Patients are no more comfortable today challenging caregiver hand washing than they were 10 years ago and a recent survey revealed that only 2/3 of patients said they would be comfortable reminding a healthcare worker to wash their hands. (1)

When asked, caregivers say they are trained to not take this type of questioning personally, but I have seen the opposite be true on more than one occasion. When polled, less than 1/3 of nurses and physicians preferred that patients remind them to wash their hands, citing among other things that it damages the healthcare worker-patient relationship. (2) For example, it’s possible and even likely that the caregiver applied hand sanitizer before entering the room but since the patient didn’t see it, the caregiver is asked to repeat it. The caregiver feels like the patient doesn’t trust him or her and the patient feels like the caregiver doesn’t care enough to comply. This is a big blow to patient satisfaction & experience.

Also, if the caregiver bristles when asked to comply, the patient feels even more awkward. Recently someone told me that although they were “appalled” at the seeming lack of hand hygiene during a recent trip to the hospital to visit a loved one, they didn’t want to say anything because they didn’t want their loved one to be afraid. After all, the loved one was already sick and in the hospital!

As healthcare providers, we need to change our attitudes. We are all acutely aware of the stats that say we as a whole only comply with hospital hand hygiene guidelines half of the time. We know this is not acceptable, yet we can’t seem to comply. What’s worse is that we cop an attitude when we are reminded.