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CDC video urges patients to insist they witness provider hand-washing


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A CDC video now being shown to hospitalized patients and visitors urges them to insist they witness providers wash their hands by the bedside, even if the doctor or nurse says he or she already washed just before entering the room.

The video portrays a young woman—perhaps a relative or spouse—visiting a patient as a doctor enters the room to perform an examination.

"Doctor, I'm embarrassed to even ask you this," the visitor says. "But would you mind cleansing your hands before you begin?"

"Oh, I washed them right before I came in the room," the physician reassuringly replies.

"If you wouldn't mind, I'd like you to do it, again, in front of me," the young woman says, insistently pointing to the gel dispenser by the door.

"Sure, no problem," the physician replies, and proceeds to do as she's told.

"Thanks, doctor. I know how important hand hygiene is in preventing infections," the patient's visitor says.

It's unclear how providers will respond if more patients become more insistent about observing hand-washing behavior at the bedside, especially if the provider really did just wash or use the alcohol gel.

But also shown in a video is a nurse or a doctor in blue scrubs saying: "Doctors and nurses don't mind being asked to wash their hands because they want to prevent infection as much as you do."

The five-minute video contains an introduction by John Jernigan, MD, a deputy branch chief with the Centers for Disease Control and Prevention.

Jernigan warns: "You came to the hospital to get well. But you should know that each year in the United States, patients get more than one million infections in a hospital while they are being treated for something else.

"Examples of infections patients can get in a hospital include infections in their blood stream, surgical wound, or urinary tract as well as pneumonia. These infections can be serious and hard to treat. But there's one simple thing you and your family can do to help prevent these infections. Wash your hands, and make sure that everyone who touches you, including your doctor, cleanses their hands too.

"Patients and their loved ones who take an active role and become involved in their treatment may have a better experience in the hospital than those who don't. And make sure everyone around you washes their hands," he says.

 

The video appears to be doing a good job at convincing patients and their caregivers not to be afraid, and to not be embarrassed for asking. Premier Inc. healthcare alliance conducted a before-and-after survey at 17 Catholic Health Partners hospitals in Ohio, Kentucky, and Tennessee to determine whether patients who watched the video were more likely to speak up or consider doing so if they didn't see their caregiver wash or use sanitizer at the bedside.

About 440 patients or family members were surveyed before they saw the video. One month later, with a different group of patients, about 440 patients or family members were asked after they saw the video.

The results showed that after the video was shown, twice as many patients were willing to ask their doctors or nurses to perform hand hygiene than before the video was provided, said Premier Inc. spokesman Alven Weil.

Nearly 1,000 nurses and 611 physicians were also shown the video at points in time both before and after the video was widely shown throughout the hospital.

Interestingly enough, doctors and nurses said they were much more likely to get reminded about washing after the video was shown, Weil said.

Studies suggest that only 50% of caregivers actually wash their hands when they're supposed to before patient contact, although 90% think they do it when they should.

Hospital acquired infections are estimated to affect more than 1.7 million patients a year, kill 99,000 patients a year, and cost between $35 billion and $45 billion a year. And, under new federal reimbursement policy, payment for care required as a result of hospital acquired infections will no longer be approved, making prevention that much more urgent.