The MP's view: Advancing hand hygiene compliance in the NHS

The 21st century NHS is facing many challenges, one of these being an increase in HCAIs. A number of healthcare workers are failing to adhere to adequate hand hygiene practices whilst at work, causing infections to hospital patients to spread. 

Research conducted by the European Centre for Disease Prevention and Control in 2011 worryingly showed that 6.4% of hospital patients – one in 16 – contracted an infection while in hospital. Approximately 300,000 patients develop a HCAI in England every year, with 5,000 of those cases proving fatal. 

My father was diagnosed with lung cancer in 2011. His initial prognosis was good, and he was expected to live for another ten years in comfort. However, shortly after having fluid drained from his lungs to relieve breathlessness, his wound became infected. Upon readmission to hospital, he was diagnosed with MRSA, and passed away a few months later. The room in which he had surgery in was also used to store cleaning equipment, and during his last months in hospital, I became acutely aware of a lack of awareness around hand hygiene from the medical staff. Since then, I have vowed to do everything I can to raise awareness around the critical importance of hand hygiene in keeping patients safe.

It is estimated that 20-40% of all HCAIs can be avoided by better communicating and better application of the existing hand hygiene rules and practices. If there is anything that can be used to support that notion, then local NHS trusts should be active in their implementation. 

Better reporting, stronger compliance

There is no doubt that doctors and nurses are best-positioned to know how to look after patients and I am by no means suggesting that anyone is deliberately avoiding washing their hands. It is more a case of identifying behavioural habits that are not being discouraged by their employers.  That is why they need support from a management level – to ensure that hand hygiene compliance is being adhered to at all times. 

Reported hand hygiene rates in the NHS are much higher than the actual rate of compliance, due to the inaccurate methods of gathering data. New ways of reporting need to be developed to ensure that workers are held accountable for delivering the safe, high quality care that the NHS is renowned for worldwide.

The common method of using direct observation to measure hand compliance is deeply flawed. The information can be subjective, imprecise and prone to false positives. For staff, knowing when they are being watched might make them overplay their regular habits, running their hand under a sanitising dispenser more frequently than they might normally – this behaviour is commonly known as the Hawthorne effect.

However, if healthcare operators can see first-hand through precise, quantifiable data that their staff are not washing their hands at the rate required to achieve compliance, then they can take action to communicate this to the healthcare workers. Electronic hand hygiene compliance reporting is readily available and provides an accurate picture of what is being done to prevent the contraction and spread of infections – not only for staff, but for patients and their relatives too, empowering them with the knowledge that the standard of care is constantly being reviewed and improved.

Supporting the existing causes

Suggesting technological reporting solutions is one thing, but we must generate the support for its implementation to make real strides. To do that, we need to make the issue more prevalent in healthcare discussions – meaning we need to back those that support the issue passionately. 

I myself know the devastating impact of HCAIs first-hand. One of the first things I did upon being elected as a Member of Parliament was launch the Handz campaign. Together with our likeminded supporters – from fellow politicians, to existing charities such as MRSA Action UK, to hand hygiene product specialists such as Deb Group – we strive to educate people, particularly the younger generation, on the importance of hand hygiene, with the view to establishing lifelong habits of good hand-washing practices.

The means to report on hand hygiene compliance in the NHS is out there. There are technical solutions that could revolutionise hand hygiene protocol and save thousands of lives each year. The difference that we can make is incalculable.