IPCWell - Infection Control Consultant & Expert - United States

Hand Hygiene seems so simple. You wash your hands for 20 seconds, you sing “Happy Birthday” twice.  (Or for you Star Wars fans, check out Doc Vader’s suggestion)

But do you know what CMS surveyors are actually looking for when it comes to hand hygiene? Not only are they watching how hand hygiene is performed, but just as importantly when it is performed.

When it comes to the CMS survey, I often see facilities struggle when it comes to hand hygiene. I understand that the proper resources aren’t always in place to make it easy, but hand hygiene is the first defense and an essential piece of infection prevention. Now more than ever it is literally lifesaving. I want you to pass your survey, and hand hygiene helps immensely to keep our residents and healthcare workers protected.

According to the CDC, alcohol-based hand rub (ABHR) is the preferred method for hand sanitizing within healthcare facilities. Many facilities still think washing with soap and water is preferred, so be sure to check your survey. It actually asks to see if you have ABHR within your facility.  Obviously if your hands are visibly soiled or dirty, use soap and water.

One often missed opportunity is conducting hand hygiene before donning your gloves. ABHR is fine also but be sure to clean hands before donning and after doffing gloves every time. Ideally, there are hand sanitizer dispensers outside every resident room. We want to make sure hand hygiene is being conducted before resident contact, after resident contact, after contact with the environment, and before and after donning and doffing gloves. Administrators, I am speaking to you when I say there should be dispensers inside and if possible, outside of every resident room. While dispensers inside every room is adequate, outside is just as important, as everyone can sanitize before entering the resident room and after leaving. Gel in, gel out.

When dispensers are readily available, we almost take the human element out, as the practice becomes hard-wired. Anybody in your facility, from staff to visitors sees the dispenser, they automatically put their hands under it and use it. This will increase compliance so much! I have personally seen compliance rates go from 30% or 40% up to 70%, 80%, and even 90% just with the addition of dispensers outside every room.

Remember, state surveyors are also watching to ensure that residents have the opportunity to conduct hand hygiene before meals and after using the restroom. If it is difficult for some residents to get to a sink, consider carrying a small bottle of ABHR and pumping some into their hands. Keeping our residents and staff safe begins and ends with hand hygiene. Here are some links to some posters for hand hygiene from the CDC, WHO, and one from the MDH that includes 24 languages on a single poster.  Thank you to all our healthcare worker superheroes out there. Be safe and be well.