Recent reports indicate that the percentage of nursing homes cited for deficiencies in hand hygiene has risen in recent years. In fact, inspectors from the Centers for Medicare and Medicaid found such deficiencies in fewer than 7.4 percent of nursing homes from 2000 to 2002, but by 2009 found them in close to 12 percent. Some states did better: Hand hygiene citations in Pennsylvania in 2009 came from just 6 percent of facilities. Some fared much worse: Michigan that year was at 15 percent.

One possible reason for the increase is the growing emphasis of infection control, which means that inspectors are likely critiquing facilities/workers more than they had previously. Another possibility is that facilities are understaffed and lack sufficient training for workers on proper hand hygiene.

According to New York Times reporting, nursing home residents are very vulnerable to infection. In fact, infections picked up in the health care setting represent the single greatest cause of sickness and death, the reason underlying a quarter of all hospitalizations from long-term care facilities.

So why not wash up? Researchers believe it is likely due to low staff numbers and an increase in nursing home residents in need of hands-on help. Pressed for time, staff often overlooks the need for proper hand hygiene.

External factors that might come into play, say researchers: Nursing homes in states with lower Medicaid reimbursement rates, for example, are significantly more likely to be cited for hand hygiene deficiencies.

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