In her blog on the Deb Group website, health hygiene researcher Carolyn Dawson discusses The WHO 5 Moments of hand hygiene - specifically when hand hygiene is being performed, and when it isn't. Because, Dawson suggests, not all hand hygiene is the same.
Examining measured hand hygiene rates using the WHO 5 Moments, for example from the Australian National Hand Hygiene Initiative, we can see hand hygiene compliance at 12.6% lower before patient contact (Moment 1) than after patient contact (Moment 4), Dawson said. In fact, a review found 35 studies reporting compliance rates before and after Patient contact, with a median compliance rate of 21% found for “before” as opposed to a much higher median of 47% found for “sfter”.
"In terms of behaviour it suggests that healthcare professionals are less likely to be performing hand hygiene before attending to their Patient, with all the related cross-contamination risk that this may imply. However, upon completion of an interaction with a Patient the healthcare professional is more likely to then perform hand hygiene." Dawson wrote
As promotion and education of the WHO 5 Moments has been significant, and successful, it has been suggested that underlying behavioral drivers may explain differing rates of hand hygiene relating to specific moments of patient care. Self-protection has been noted as a strong motivator for hand hygiene in doctors, over and above the need to prevent cross-contamination. This may explain why hand hygiene is seen more frequently AFTER patient contact, when a perceived risk to the healthcare professional drives the behavior, whereas BEFORE patient contact requires a driver stemming from a desire to prevent potential contamination reaching the patient.
Read the blog.