I know you're dying to find out. How are we doing on hand hygiene? Are we finally coming to our senses? Am I a happy man yet?

Well - sort of.

The staff on some units truly "get it." From August through December, 2008 audits showed that in adult GI and in special care nursery the staff engaged in hand hygiene 100% of the time both before and after patient contact. On 6WP the numbers were 99% before and after (yes - one person was observed not to do so, but everyone else was perfect). These units deserve our praise. They are protecting themselves and their patients in an exemplary way.

On the other (unwashed) hand, on other units there was as low as 70% pre- and 81% post-patient contact hygiene. Not so good.

Overall, the numbers were 80% pre- and 84% post-patient contact.

Between August and December there was a trend of improvement overall, to 83% pre- and 89% post.

As for how various categories of folks are doing, there is good news and bad news. Hand hygiene by nurses hospital-wide has increased to 92% pre-care and 96% post-care in December. Excellent! PCAs are next with 89% pre- and 91% post. Also very good.

And guess who remain pathetic. You're right - the physicians, with 64% pre and 77% post. Duh. I think it was Groucho Marx who once said he'd never want to belong to a group that would accept him as a member. I'm starting to feel that way about my colleagues.

For caregivers in other categories, the numbers have steadily increased to 79% pre and 88% post-care in December.

So am I a happy man? Sort of. Our goal must remain 100% compliance. Some of our colleagues have gotten there. Others - especially physicians -- are slow learners. But I must remain optimistic that even they eventually will catch on. After all, they have improved from about 50% compliance in August.

We have circulated complete statistics to supervisors. If you are on a less than perfect unit, after you have recovered from the shock and stopped crying, JUST DO IT! This is not rocket science. And doctors - wake up!

We can all attain 100% compliance.

Make me a happier man.

From Mark S. Drapkin, MD,
Hand Hygiene Champion

PS: My huge thanks to all those who make observations and gather these data and to Dan Hogan and Susan Macdonald for organizing and reporting them. Let's give them a big (clean) hand!