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Handwashing non-compliance irks authorities

Getting worse, new stats show

By: Larry Kusch

Posted: 10/17/2012 1:00 AM | Comments: 0

(WINNIPEG FREE PRESS)

HOSPITAL administrators are losing patience with Winnipeg doctors, nurses and health-care aides who repeatedly fail to wash their hands before caring for patients.

According to statistics the Winnipeg Regional Health Authority released Tuesday, the situation is generally getting worse, despite a three-year effort to prod health workers to improve their hand-cleaning.

An audit of city hospitals conducted over the spring and summer found several had lower compliance rates than last year or showed marginal improvement.

"This does not reflect well on us as a system, as health-care providers or as professionals," WRHA president Arlene Wilgosh said in releasing the figures during Bug Day, a medical conference devoted to infectious diseases, public health and infection prevention and control.

The latest handwashing audit revealed about 50 per cent of the time, staff at city hospitals are not washing their hands when they should — before and after touching a patient.

Generally, nurses and health-care aides washed their hands more frequently than doctors — but still not nearly as frequently as they should. Health-care aides and nurses at St. Boniface General Hospital had the best compliance rates in the city, at 69 and 68 per cent respectively.

But doctors at St. B were the least likely among hospital MDs to clean their hands when required — just 17 per cent of the time, Wilgosh said, a figure that drew gasps and a shocked buzz Tuesday at a Health Sciences Centre lecture theatre jammed with doctors, nurses and students.

Wilgosh said the Winnipeg Regional Health Authority plans to publish the results of future handwashing audits on its website, beginning in the new year, to inform the public — and perhaps to shame staff into improving its record. It will also encourage patients to remind caregivers to clean their hands. The WRHA is seeking an overall compliance rate of 90 per cent.

John Embil, the health authority’s director of infection prevention and control, said administrators have been hesitant to discipline staff for failing to wash their hands when required. But that may change if education and hounding don’t work.

"At some point the regional leadership is going to have to say, ‘Enough is enough. And if you don’t comply, these are the consequences,’ " Embil said Tuesday.

"We’ve talked this to death and at some point we need to take some sort of aggressive action."

Wilgosh said the people who conducted the audit were in full view of hospital workers, sporting clipboards on which they recorded whether or not staff washed their hands or used sanitizers. They also explained to staff what they were recording.

Wilgosh noted the poor results come at a time when hospitals across Canada are spending tens of millions of dollars battling the spread of infection and socalled superbugs within their institutions — money that could be spent instead on patient treatment if sanitation efforts were improved.

The health authority boss was also "a little distressed" by stats that showed medical staff were much more likely to clean their hands after seeing a patient than before. At the Victoria General Hospital, for instance, 28 per cent of staff cleaned their hands beforehand while 69 per cent did so afterwards. At Seven Oaks, 35 per cent cleaned up beforehand and 75 per cent did so afterwards.

"What these numbers show is that we’re more concerned about taking care of ourselves than we are in taking care of patients," Wilgosh lamented.

Conservative health critic Cameron Friesen called the poor handwashing rates a safety issue. He said his party is discouraged that the situation is not improving. "Surely this is a simple fix and the health minister could have tackled this," Friesen said.

Health Minister Theresa Oswald, attending the kickoff for the province’s annual flu shot campaign Tuesday, said if anyone needs lessons on handwashing, they should ask their kids. "Any adult that wants a lesson in handwashing... should drop in at their local daycare," Oswald said in response to the study.

Meanwhile, a Queen’s University medical professor attending the Winnipeg conference said Ontario has made great strides in recent years in getting hospital workers to clean their hands through sheer persistence — frequent reminders and regular audits that are posted online and in hospital wards.

— with file from Alexandra Paul

larry.kusch@freepress.mb.ca

Republished from the Winnipeg Free Press print edition October 17, 2012 A6

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