Joint Commission Pushes For Improved Hand Hygiene

Adding to hospital facility managers’ stress level is a new rule from The Joint Commission. As of January 1, 2018, they will begin to cite “…observations by surveyors on individual failure to perform hand hygiene in the process of direct patient care…” as a deficiency and will result in a Requirement for Improvement.

Previously, hospitals were not cited for individual failures of hand hygiene performance, as long as the organization was able to show a hand hygiene program with progressive compliance rates. But, because hospitals have now had more than a decade to get a successful program in place, it has determined that it is time for further action.

The Joint Commission has acknowledged that there are many reasons for HAIs, but they have found that, “failure to perform hand hygiene associated with direct care of patients should no longer be one of them.”

“Their thinking probably was, ‘What is it going to take for hospitals to get serious about hand hygiene?’ Centers for Medicare and Medicaid Services (CMS) financial penalties don’t seem to be working,” says Darrel Hicks, author of Infection Prevention for Dummies. “I believe this new Joint Commission rule will help, but there must be consequences. For example, I know of one hospital that has a three strikes penalty. Three strikes are grounds for dismissal. It will take time for the news to travel if someone is fired, but it might take this kind of action to move the dial in the right direction.”

Solutions For Improvement

The pressure is on for hospitals to improve hand hygiene and reduce HAIs. The stakes couldn’t be higher and the lifesaving tools — soaps and sanitizers — are there. Those tools just need to be used correctly and more frequently, experts say.

“We’ve already seen too many studies that showcase poor hand hygiene compliance rates in hospitals. From the literature we’ve seen over the years, there can be different factors leading to low compliance rates: the location of the soap and sanitizer dispensers, empty dispensers or poor hygiene education programs,” says Brian Sansoni, vice president of sustainability initiatives at the American Cleaning Institute in Washington D.C. “Point blank, hospital facility managers need to equip the front-line personnel with the weapons that they need to combat and prevent infections that can kill people.”

It makes sense for facility cleaning managers to provide the products that best meet employees’ needs, as Sansoni states. Do they want antibacterial soap? Soaps with moisturizers to help avoid skin irritation? What types of hand sanitizers work best? These questions can be addressed in departmental meetings.

Having the tools in place is one key element of an effective hand hygiene program, but monitoring is necessary, as well. Because of the limitations of observation, however, there is increased interest in new technologies that can audit and provide feedback on handwashing compliance.

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