April 29, 2021

Handwashing compliance spiked in 2020. (But the habit isn't sticking.)

Daily Briefing

    Handwashing rates among health care providers and the American public, which were high early during the Covid-19 pandemic—but a new study published in JAMA Internal Medicine and a survey from the Bradley Corporation indicates that handwashing rates among both groups have fallen to pre-epidemic levels, Sandee LaMotte reports for CNN.

    How Covid-19 is changing the future of the health care industry

    How often health care providers are washing their hands

    For the JAMA study, researchers measured data from an automated hand hygiene monitoring system installed at the University of Chicago Medical Center in 2015. The system uses an infrared sensor to anonymously record all uses of each dispenser throughout the hospital, as well as entries and exits from inpatient rooms.

    The researchers examined hand hygiene compliance from September 2019 through August 2020 in the hospital's regular units and its "Covid cohort units," which focused solely on caring for patients with Covid-19. According to CNN, providers and staff throughout the hospital should wash their hands upon entering and exiting a hallway or room to avoid spreading patient bacteria.

    Overall, the researchers found that on March 29, 2020, compliance hit a daily peak of 92.8% among all units in the hospital and, during the week of March 29, 2020, a weekly peak of 88.4% among all units. Among the Covid-19 units specifically, the researchers found that on March 28, 2020, compliance hit a daily peak of 100% and, during the week of March 29, 2020, a weekly peak of 98.4%.

    However, by August 15, 2020, across all units, hand hygiene compliance dropped to a daily rate of 51.5% and a weekly rate of 55.1%.

    According to Emily Landon, co-author of the study and executive medical director of infection prevention and control for University of Chicago Medicine, hand hygiene compliance appears to have peaked at the start of the pandemic, when staff "were really worried about Covid—they didn't know who had Covid and who didn't—so they were extremely careful."

    She explained that one way providers minimized the odds of spreading patient bacteria early in the pandemic—in addition to hand-washing—was to "bunch" their patient duties together, so they could enter a given room or hallway less frequently. However, as time progressed, staff started dropping in and out of rooms to check on patients again, Landon said.

    "It may be a little bit of a shock to most Americans that some doctors and nurses are not cleaning their hands," she said, "but it's because of all those sort of quick in and outs that we often do."

    Despite the decline, however, Landon said the 51.5% rate was fairly strong. "The reality is that when hospitals look at their hand hygiene in a comprehensive way, where they measure every single hand hygiene event that is supposed to happen, they often find that they're running about 30% compliance," she said. "So our 51.5% is actually quite good."

    How much the American public is washing their hands

    Separately, a new survey from the Bradley Corporation, a commercial bathroom fixture company that frequently conducts surveys on handwashing habits in the United States, found that in January, just 57% of Americans said they wash their hands at least six times a day. In comparison, when the survey was conducted in April 2020, 78% of respondents said they washed their hands that often.

    The study also found that so-called "rinse and runs" had increased. "We call it the 'rinse and run' where you go into a public bathroom and don't take the time to use the soap—you just rinse you hands and run out the door," Jon Dommisse, director of strategy and corporate development for Bradley, said. "In April 2020, only 27% admitted to doing that. In January of this year, it was up to 48%."

    For those who want to improve their hand-washing frequency, Landon suggests establishing "some rules for yourself."

    For instance, she said she asks guests when they arrive at her home to wash their hands. "Our house rules are we wash our hands before we eat, we wash our hands after going to the bathroom, and we wash our hands when we come inside from an activity, such as going into work or returning home," she said (LaMotte, CNN, 4/26).

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