The study, which was published online in Infection Control and Hospital Epidemiology, found that hospital patients only wash their hands about 30 per cent of the time in the washroom, 40 per cent of the time for meals, and only three per cent of the time when using the kitchens in their units.
Hand hygiene rates were also low when entering or leaving their hospital rooms, at about three per cent and seven per cent, respectively.
“This is important because getting patients to wash their hands more could potentially reduce their risk of picking up infections in the hospital,” said Dr. Jocelyn Srigley, the study’s primary researcher, who is also the associate medical director for infection prevention and control at Hamilton Health Sciences.
While plenty of studies have focused on hand hygiene for doctors and nurses, there has been little emphasis on the way patients wash their hands to reduce the spread of infection, researchers say.
For the study, Srigley and her team studied the hand washing habits of 279 adult patients in three multi-organ transplant units of a Toronto acute care teaching hospital over an eight-month period. Researchers used new electronic monitoring technology with sensors on soap and sanitizer dispensers to track how much people washed their hands.
Lack of focus on dirty hands
Srigley says there’s a lack of focus on patient hand hygiene in Canadian hospitals, so its results aren’t surprising. Even health care worker hand washing habits are far from ideal despite official efforts to fix it, she says.
“At the hospital where this study was conducted, patients were not given any specific information about hand hygiene,” she said. “We can't expect patients to know when to wash their hands if we don't inform them, so it's not surprising that they wash their hands infrequently.
“In particular for washing hands when entering and exiting their room, it's not something that I would expect patients to think of doing unless they were educated and reminded to do that.”
According to researchers, it’s important that patients see hand washing as a priority, seeing as organisms like C. difficile or norovirus can survive on skin and surfaces, contaminate patients’ hands, and then be ingested, leading to infection.
Cleanliness an issue, CBC report finds
According to 3,500 submissions to an online survey about patient experiences done by CBC’s the fifth estate, nearly a third of respondents, who included patients, health-care workers and relatives and friends of patients, said hospital rooms and bathrooms were not kept clean.
A World Health Organization report that compared Canada's infection data with that of 12 other wealthy countries found that Canada had the second-highest prevalence (11.6 per cent) of hospital-acquired infections after New Zealand — much higher than that of Germany (3.6 per cent) or France (4.4 per cent).
C. difficile infections, in particular, which generally afflict patients who are already vulnerable and are fatal in about five to 10 per cent of cases, have been on the rise not just in Canada but in the U.K. and the U.S. as well.
In the last 10 years, there have been several high-profile outbreaks of the superbug in hospitals in Quebec, British Columbia and Ontario that resulted in patient deaths. Those three provinces continue to have the highest prevalence of C. difficile.