Clinical Care

Are we failing at our most essential task?

Hand-hygiene adherence continues to fall below the standards of a top-performing health system.


In April, STAT sounded the alarm over falling hand-hygiene rates at all three of our hospitals. It’s disappointing to note that while some hospitals have seen slight improvements, overall compliance remains lower than in the spring.

This summer, compliance at ARRMC dropped significantly, as did the rates at AACH, which frequently boasted 100% adherence in past years. ATRMC’s rates met the 90% target in two of the monthly reporting periods (good job!), yet it too hasn’t regained the 99% adherence numbers it had six years ago.


Observations have found two areas where we can improve:

  • Cleaning hands between leaving one patient room and entering another — always.
  • Washing hands before donning gloves — always.

Hand hygiene has very real consequences for our patients. Hospital-acquired C. difficile infections have risen substantially, posing a safety risk to our patients. This potentially deadly organism, which colonizes in the intestines after antibiotic therapy alters normal gut flora, has surpassed MRSA as the leading germ threat. It can lead to pseudomembranous colitis, toxic megacolon, perforations of the colon and sepsis. It infects nearly half a million Americans a year and kills more than 15,000.

It can be prevented if staff follows enteric isolation practices, wash their hands with soap and water (the bacteria can’t be killed or easily sloughed with alcohol-based rubs), and keep clean equipment used to treat patients with C. diff to prevent cross-contamination.

Health-care-acquired infections are a challenge for every health care organization. We know from our own experience, however, that proper hand hygiene can vastly reduce the number of C. diff, MRSA, CLABSI and CAUTI infections in our facilities.

We have met this challenge before and have regularly exceeded 90% adherence. Our patient safety practices are among the reasons Asante has been a 15 Top Health System 10 years in a row. As we recover from the effects of the COVID-19 pandemic, let’s not forget our most basic safety precaution: Keeping our hands clean.

To learn more about hand hygiene, please consult our policy. You can find information on all hospital-acquired infections on myAsanteNET.

Tags: adherence, C.Diff, CAUTI, CLABSI, Hand hygiene, Holly Nickerson, STAT
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