A report from the Health Information and Quality Authority (Hiqa) this week found that medical staff at Beaumont Hospital in Dublin were putting patients at risk of infection by failing to follow proper hand-hygiene techniques while on ward rounds.
It highlighted that hand hygiene in the neurosurgical intensive care unit and the emergency department was out of step with best practice and of 60 “hand-hygiene opportunities” observed by inspectors, only 28 were taken.
Beaumont was highlighted this week but it is not the only hospital that has been found wanting. Two years ago, a survey of more than 5,000 patients in 25 hospitals found that only 60 per cent said staff always washed their hands before treating them.
The benefits of hand-washing have been known for 150 years. They were first highlighted by Hungarian doctor Ignaz Semmelweis in the mid-19th century. He put together a dossier about dramatically reduced mortality rates among new mothers when doctors washed their hands. His anecdotal evidence was compelling but he lacked a scientific explanation and was eventually committed to a mental asylum where he was beaten to death by guards.
It’s hard not to some feel sympathy for medical staff. Working conditions are tough but patients still have a right to expect basic levels of hygiene.
But can a sick, scared and vulnerable person who sees poor hand hygiene do anything about it? Can they challenge the very people who are, in many instances, keeping them alive? The short answer is yes.
Every hospital in the State has a patient charter and every charter makes reference to hand hygiene. The HSE has run several campaigns encouraging patients to be proactive about the issue and to ask medical staff if they have washed their hands.
Minister for Health James Reilly said earlier this year that all healthcare staff "need to ensure that they have received hand-hygiene training and that they are familiar with the five moments".
Patients would do well to know these moments too. Guidelines from the World Health Organisation say medical staff need to "wash hands before touching a patient, wash hands before commencing a cleaning or aseptic procedure, wash hands after a body fluid exposure risk, wash hands after touching a patient and wash hands after touching patient surroundings."
Anything else is not good enough.