The last thing hospital administrators want to do is raise costs. In light of price increases seen across the board for medical supplies, they would frown upon spending money on incremental materials. It is no surprise that advocating a hand hygiene program can be quite challenging especially if it requires a budget. This article will show how investing in a hand hygiene program can save hospitals in the long run.
Correlation of Hand Hygiene and Infections
In the United States, healthcare associated infections, also known as hospital acquired infections, lead to nearly 100,000 deaths annually. The Center for Disease Control and Prevention (CDC) defines healthcare-associated infections (HAIs) as infections acquired during the time the patient was in a hospital for other conditions. As an example, let’s consider a person who receives an infection while visiting the doctor for a standard checkup. This scenario would be classified as a HAI. On the flipside, if a person receives an infection due to an existing condition like an open wound, this infection would not be classified as an HAI.
Healthcare associated infections results from the transmission of germs spread around due to a combination of reasons which include having a high concentration of sick individuals inside hospitals and poor hand hygiene practices.
Hands are the number one method of transmitting harmful pathogens to another person. This fact is not surprising when you think about how hands touch patients and regularly touch objects where microorganisms can reside. If handwashing is not done properly, germs will continue to spread and increase the prevalence of healthcare associated infections. In a study conducted by the CDC, the average hand hygiene compliance rate in American hospitals is roughly 40%. This statistic is horrible and infection control practitioners agree that if we can have more healthcare workers and visitors wash their hands regularly, the number of healthcare associated infections would drastically reduce. Every year there are nearly 1.7 million HAIs in the United States and this means that at least 5% of patients admitted in hospitals receive HAIs. This calculates to 5% of victims to healthcare associated infections leading to death.
Cost of Healthcare Associated Infections
In the state of Pennsylvania, the number of healthcare associated infections increased 58% to 30,237 reported cases in 2006 compared to 19,154 cases in 2005. Looking at the data, the mortality rate of patients who acquired HAIs was 6 times higher than patients without HAIs. We recognize that the cost of human life is high, but the study goes beyond and calculates the operational costs of the healthcare facilities. On average, the hospital charge for admitted patients without HAIs was $33,260. In contrast, the average hospital charge for admitted patient with HAIs was $175,964. In addition, the average length of stay in hospital while the patient was admitted was higher by 5 times the amount in patients with HAIs. The findings of this study draw the conclusion that HAIs are responsible for a large chunk of health care costs. Experts agree that the single most effective measure for combating HAIs in hospitals is improving hand hygiene which leads to a reduction in the high costs of health care.
Hand Hygiene Program’s Effect on Healthcare Associated Infections
Hand hygiene programs are an investment to healthcare facilities because when more and more workers practice good hand hygiene, the rate of hospital acquired infections are shown to decline. In Switzerland, a hand hygiene program was implemented at the University of Geneva hospitals and was able to improve and sustain the hand hygiene compliance rate from 48% to 66% resulting in a significant decline in the number of HAIs. Dr. John Boyce, chair of Hand Hygiene task force at CDC, stated that if hospitals are able to sustain hand hygiene compliance rates of 70-80%, a substantial reduction of healthcare-associated infections would be seen.
Most hospitals in the United States have implemented some form of hand hygiene program; however, not all hospitals have committed the same amount of resources. Successful hand hygiene programs report that campaigns must be implemented hospital-wide to make a lasting impact. The state of Pennsylvania adopted a campaign encouraging patients to ask clinicians, “Did you wash your hands?” This campaign continues to see success as efforts are cooperatively supported from the administration level down to each worker’s unit.
The incremental operating cost of a healthcare associated infection is calculated at thousands of dollars. If a hand hygiene campaign is able to prevent one HAI, the efforts will not have been for naught. Experts from CDC and APIC speak with unison regarding the need to improve hand hygiene around the world. Preventing healthcare-associated infections is the best way of attacking the HAI problem and good hand hygiene is recognized as the single most effective method of preventing HAIs. Handwashing does saves lives!
- Pennsylvania Health Care Cost Containment Council. Hospital-Acquired Infections in Pennsylvania - Calendar Year 2006. April 2008. www.phc4.org.
- Haas J, Larson E. Compliance with Hand Hygiene Guidelines. AJN, American Journal of Nursing. August 2008;volume 108, number 8:pages 40-44.
- Littau, C. Clean Up on Hand Hygiene Compliance. Materials Management in Health Care. October 2007.
- Center for Disease Control and Prevention. Healthcare Associated Infections.
- Association for Professionals in Infection Control and Epidemiology.