Even though nurses and other healthcare workers are supposed to wash their hands each time they enter a patient’s room, a new study has found that hand-washing decreases toward the end of a caregiver’s shift.
The reason? As they become mentally fatigued, busy hospital workers may focus more on their chief tasks, such as evaluating patients and dispensing medication, and less on complying with hand-hygiene standards.
“This decline in compliance was magnified by increased work intensity,” according to the study published in November 2014 in the Journal of Applied Psychology.
The researchers reviewed three years of data relating to more than 4,100 caregivers in 35 hospitals nationwide. Nurses accounted for 65% of the healthcare professionals; other categories of workers included physicians, therapists and patient care technicians.
Researchers tracked hand-washing habits using data from Proventix, which provides radio frequency identification (RFID) technology to healthcare providers. Communication units attached to soap and sanitizer dispensers recognize employees’ RFID badges and relay information back to a centralized database.
The study, which was published by the American Psychological Association (APA), found that hand-washing compliance rates dropped by an average of 8.7 percentage points during a typical 12-hour shift.
Nationwide, hospital patients develop more than 720,000 infections annually, the federal Centers for Disease Control and Prevention reported in 2014. Hand hygiene is considered a key component in halting the spread of infection; indeed, the World Health Organization identifies it as “the primary measure proven to be effective in preventing” healthcare-associated infections.
Along with reducing infections, higher rates of compliance with hand-washing policies could bring cost-saving opportunities for healthcare administrators. Citing previous research, the authors of the new study calculated that an 8.7 percentage point decrease in compliance rates among all U.S. hospitals would lead to additional healthcare costs of $12.5 billion each year.
The authors, who included researchers from the University of Pennsylvania and the University of North Carolina, also identified a potential solution: longer breaks. Periods of rest seemed to give workers the mental stamina they needed to meet hand-hygiene standards.
Even “small improvements in compliance can potentially translate into meaningful reductions in healthcare-associated infections” considering the vast number of daily interactions between healthcare workers and patients, the study noted.