Hand hygiene: what about our patients?

Effective hand hygiene practice within health care is widely recognised as being one of the single most important interventions to control and prevent the spread of healthcare associated infection (HCAI). This study aimed to explore nurses' and patients' perceptions towards patient hand hygiene and determine whether patients who required assistance with their hand hygiene were encouraged and offered appropriate facilities at appropriate times. In January 2007, within an acute teaching hospital in Scotland, six observational sessions, each lasting 4 hours were undertaken, 33 nurses completed a survey questionnaire, and interviews were carried out with 22 patients who required hand hygiene assistance. 100% of nurses and 95% of patients believed that patient hand hygiene was an important part of controlling and preventing HCAI. 64% of nurses reported having offered patients facilities to decontaminate their hands during the observational period, but only 14% of patients agreed with this. Out of 75 patient hand hygiene opportunities identified, facilities were provided on only one occasion. Despite nurses believing patient hand hygiene is an important part of preventing and controlling HCAI, unless patients are able to undertake this task independently, they are rarely encouraged or offered facilities to do so.