Poor Patient Hygiene Increases Hospital Infection Risk

STAMFORD, Conn. — Hospital patients may be at risk of infection due to their own poor hand hygiene, according to a new study.

A University of Toronto study, published in the October 2014 issue of Infection Control and Hospital Epidemiology entitled “Measurement of patient hand hygiene in multi-organ transplant units using a novel technology: an observational study,” analyzed the movement and behavior of staff, patients and equipment in a Toronto hospital. Researchers used the Hospital Watch Live System from Toronto-based health care IT company Infonaut.

The study, which continuously monitored and measured hand hygiene among hospital patients, is the first study of its kind. The study found that in more than 12,000 bathroom visits, patients washed their hands only 30 percent of the time on average. Data from meal times revealed that hand hygiene was lowest at breakfast (30 percent) and highest at dinner (45 percent). Average patient hand hygiene when entering and leaving their rooms was less than 5 percent and even lower for visits to patient kitchens.

The technology that enabled the study uses what is being called “Sonitor” positioning ultrasound tags. These tags are worn by patients and staff and are placed on equipment. Sonitor ultrasound tags are also integrated with soap and hand sanitizer dispensers to signal when they are used. The movement of people, including instances of performing hand hygiene, are captured automatically then geospatially analyzed.

The analysis was led by epidemiologist Dr. Colin Furness, Infonaut’s director of research and knowledge development, and an adjunct professor at the University of Toronto’s Faculty of Information. Dr. Furness worked with first author Dr. Jocelyn Srigley, the associate medical director of infection prevention and control at Hamilton Health Sciences.

“The extent of this problem has not been visible until now because it has not been measurable until now,” said Furness, a co-inventor of Hospital Watch Live, in a statement. “Enormous resources are devoted to research and practice for improving staff hand hygiene compliance, but patient hand hygiene has received scant attention.”

The study suggested that there may be benefits to including patients in hand hygiene promotion campaigns.

“This is important because getting patients to wash their hands more could potentially reduce their risk of picking up infections in the hospital,” Srigley said in a statement.

Many dangerous pathogens commonly found in hospitals, including C.difficile, enter through patients’ mouths via contaminated surfaces in bathrooms and other areas.

“Patients’ mouths are surely touched the most by their own hands, not health care workers’ hands,” Furness said in a statement.