Importance of Handwashing in the Hospital Setting

Handwashing is taught at a young age, but how often do people actually wash their hands for the proper amount of time after using the bathroom, shaking someone’s hand, or eating a meal? While in the hospital setting, handwashing is extremely important in order to prevent hospital- acquired diseases; also known as nosocomial infections. Three types of pathogens that can cause nosocomial infections are bacteria, viruses, and fungal parasites. According to Maryanne McGuckin, LDI senior fellow, “about 5% of people admitted to U.S hospitals (about 2 million people) acquire an infection there” (McGuckin). Handwashing is an effective way to help reduce the number of nosocomial infections that occur among patients, family members, and hospital staff.

One of the most common pathogens to cause nosocomial infections is due to bacteria. A common example of a bacteria nosocomial infection is Clostridium difficile. According to Dr. Surawicz, C. diffcile is the “leading cause of hospital-associated gastrointestinal illness and places a high burden on our health-care system” (Surawicz). C. difficile is a gram-positive bacterium that is usually spread by oral-fecal route. Patients that develop C. Diff are noted to have extended length of stay in the hospital and it is responsible for large hospital outbreaks of disease (Surawicz). C. difficile is “transmitted from an infected patient to others through healthcare staff via improper cleansed hands” (khan). Healthcare staff should be washing their hands before and after touching a patient. C. difficile occurs in 5–15% of healthy adults and up to 57% in residents in nursing homes/assisted living. Transmission results mostly from environmental surface contamination and hand carriage by staff members and infected patients (Surawicz). Another type of bacteria that causes nosocomial infections is Methicillin-resistant S. aureus (MRSA). It can be transmitted through contaminated hands, direct contact or open wounds. MRSA can cause “sepsis, pneumonia and SSI by travelling from organs or bloodstream. It is highly resistant towards antibiotics called beta-lactams” (Khan). Both of these bacterial infections are difficult to treat and easy to transmit between people.

The next common pathogen that can cause nosocomial infections are viruses. According to Hassan Khan, “usual monitoring revealed that 5% of all the nosocomial infections are because of viruses and they can be transmitted through hand-mouth, respiratory route and fecal-oral route” (Khan). A common virus in the hospital setting is Influenza. Nosocomial influenza outbreaks “occur in almost all types of hospital wards, and their consequences for patients and hospitals in terms of morbidity, mortality and costs are considerable.” (Voirin). Influenza is easily transmitted between people and is very hard to determine the source due to so many people coming and going. However, handwashing of the staff and family can help protect the patient from becoming infected. The last type of pathogen that causes hospital acquired infections are fungal parasites. Fungal parasites act as “opportunistic pathogens causing nosocomial infections in immune-compromised individuals” (Khan). Three examples of fungal parasites are Aspergillus spp, Candida albicans, and Cryptococcus neoformans. Aspergillus spp causes infections through environmental contamination while Candida albicans and Cryptococcus neoformans are responsible for infection during hospital stay” (Khan). All three types of pathogens can help be prevented by proper handwashing by the hospital staff, family and patient.

In order to properly wash your hands, it is good practice to use warm water with soap and forcefully scrub for at least 20 seconds. Not only should you wash your hands after using the bathroom, but you should also wash them before/after eating, after touching someone else, and after blowing your nose, etc. According to Maryanne McGuckin, “simple educational interventions aimed at hospital staff (such as lectures, practical demonstrations, or written material) have had only a short-term influence on handwashing behavior. Multifaceted approaches that combine education, reminders and continuous feedback to staff show more promise, but they can be prohibitively expensive to maintain and monitor in the long-term” (McGuckin).

Hospitals need to start educating not only their own staff, but every person that enters the hospital. Hospital staff’s hands are “the most common vehicle for the transmission of healthcare-associated pathogens from patient to patient and within the healthcare environment…hand hygiene is the leading measure for preventing the spread of antimicrobial resistance and reducing healthcare-associated infections” (Allegranzi). It would be good practice to have every person wash their hands as soon as they arrive at the hospital as well as giving them a pamphlet on proper handwashing and when it should occur. Epidemiological studies suggest “that one-third of nosocomial infections could be prevented by well-organized infection control programs” (McGuckin,). A study was performed in New Jersey at 4 different hospitals and patients were to read brochure about handwashing. According to the study, more than 80% of the patients read the brochure and 95% recognized the importance of handwashing to prevent infections (McGuckin). Each hospital had an average increase in soap usage by about 34%, which means more people were washing their hands more often. Handwashing is proven to decrease the spread of infection and not only benefits yourself, but other people.

Handwashing is the responsibility of each and every person, but without proper education many people do not wash their hands correctly or do not wash them at all. The first step to help reduce the amount of nosocomial infections is to educate the public and hospital staff. We should be encouraging people to wash their hands even when they do not see the need to so because pathogens are too small to see with the naked eye and you never know how well something was cleaned. It’s time to start reducing the amount of hospital-acquired infections and start practicing proper handwashing!