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It´s okay to ask?

Portrait of Noel Abela, MSc Infection Control and Public Health
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Can we all get even better in our Hand Hygiene Compliance? This was the title of an investigation, presented on May, 5 on the occasion of the National Infection Conference in Malta. With Noel Abela, MSc Infection Control and Public Health
from the Mater Dei Hospital in Malta  spoke Carola Timmel.

Mr. Abela, one week ago you presented a survey which was the result of an interactive session with healthcare workers (HCWs). You asked 95 people about various aspects in the context of Hand Hygiene Compliance. The results of one question seem to me especially interesting: Should patients ask HCWs to perform HH before any procedure? 80 percent of the interviewed HCWs said “yes” – this is amazing, HCWs themselves obviously want to have more pressure to do this essential measure?
The delegates that took part did not find it uncomfortable or awkward that a patient will ask them to perform hand hygiene. For the 20 percent that said “no” they expressed that being asked by patients will put them in an awkward uncomfortable position. I think it all boils down to culture. If you look at the US or the UK this is not an issue since this is part of their culture that patients can ask them to perform Hand Hygiene.

What measures were done in the US an UK to support this positive attitude among the healthcare workers?
The US and UK have taken this on board as part of their National Hand Hygiene Campaign. There are some campaigns, such as It’s okay  to ask that were successful. The aim of this initiative is to invite patients to directly ask staff about Hand Hygiene.
There was a survey in the UK where 71 percent of all HCW’s that took part agree that patients should ask HCWs to perform Hand Hygiene as a reminder.

Could the reminder of the patient play a decisive role in the fight against nosocomial infections?
Absolutely. Patients could play an important role being active participants in changing staff behaviour. Its important that patients feel safe when having treatment. Patients should expect to see staff cleaning their hands before they are cared.

Do exist any representative investigation in that field?
Yes. There was one under the lead of Prof. Didier Pittet (WHO Collaborating Centre on Patient Safety), published in the Journal of Hospital Infection, in 2010. Most HCWs surveyed (178/254, 71%) said that Healthcare Associated Infections (HAI) could be reduced to a greater or lesser degree if patients asked HCWs if they had cleaned their hands before touching them. Inviting patients to remind HCWs about hand hygiene through the provision of individual alcohol-based hand-rub containers and actively supporting an It’s okay to ask attitude were perceived as the most useful interventions by both – patients and HCWs.

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