Can Hand Hygiene Prevent Nursing Home Deaths?

Good hand washing practices may seem like an inconsequential part of everyday life, but can better hand hygiene prevent nursing home deaths? New research suggests that yes, better hand hygiene practices could potentially save lives and reduce the number of infections in nursing homes.  Let’s take a closer look at the research, and explore what you can do to keep your loved one’s safe from poor hygiene practices.

Better Hand Hygiene Could Save Lives

Infections are among the leading causes of illness and death among individuals in long-term care settings.  Every year, around three million people are impacted by infections in the nursing home setting.  According to an article published in the American Journal of Infection Control, consistent hand hygiene among nursing home staff, residents, and visitors could reduce the rate of infection, rate of antibiotic prescriptions, and overall, reduce the mortality rate.

Researchers examined 26 nursing homes in France between April 2014 and April 2015.  Divided in half, 13 nursing homes were in the control group, and 13 were part of the intervention.  The intervention group received resources such as hand-sanitizer, new dispensers, promotional posters, and online quizzes once the program was concluded.  The results were as follows:

  • The death rate in the intervention group was lower than the control group, with 2.10 and 2.65 deaths respectively.
  • Antibiotic prescription rates also declined among the intervention group, with only five daily doses, as compared to 5.8 per 100 resident days.
  • The mortality rate in the intervention group was 30 percent lower than in the control group.

Researchers noted that during the spring and summer, the number of antibiotic prescriptions declined.  During the fall and winter months, the number of prescriptions increased again, especially during January and March 2015 when there was a severe flu outbreak that targeted older adults.

Researchers also noted that better hand hygiene could be responsible for increased life expectancy among older adults who contracted the flu.  Rather than succumbing to the flu itself, many adults survived the flu, but then died later due to other morbidities.  Consistent hand hygiene practices were linked to three to six month increases in life expectancy.

Is Hand Hygiene Really an Issue?

Most of us would like to think that hand hygiene is a ‘no-brainer’, especially for adults.  But the truth is, nearly everyone could benefit from better practices.  According to the Centers for Disease Control and Prevention (CDC), healthcare providers wash their hands at varying degrees of effectiveness, and often do not cover all surfaces of their fingers and hands.

The CDC also noted in 2002 that adherence to healthcare worker (HCW) hand hygiene procedures is poor among U.S. healthcare settings.  On average, HCW hand hygiene compliance is 40 percent.  Adherence is even less in other countries, such as Canada, whose level of compliance is only 14.7 percent.

Poor adherence has been linked, in research, to include risk factors such as:

  • Professional category: such as being a physician versus a nurse or physician’s assistant
  • Hospital ward
  • Day and time of the week
  • Type of patient care required
  • Number of opportunities for hand hygiene per hour
  • Use of gloves (healthcare providers are less likely to wash their hands immediately upon glove removal)
  • Research has shown that non-adherence is most common among nurses during the weekend

The CDC indicates one particularly dangerous factor affecting hand hygiene practices – the greater the demand for good hand hygiene, the less the adherence.  For example, healthcare providers in an intensive care setting had lower adherence than providers in other areas where the intensity of patient care is less.

Why is Hand Hygiene an Issue?

Hand hygiene practices in the healthcare setting date back to the early nineteenth century.  As science and medicine have advanced, so has the importance of good hand hygiene to reduce the risk of transmitting germs and bacteria.  Unfortunately, many HCWs struggle to develop consistent hand hygiene practices.  Others may simply be negligent in how they manage hygiene, or may not value the importance.

There is no clear reasoning for why the importance of hygiene is not a more prominent fixture in healthcare settings, including nursing homes.  Researchers have identified certain factors that deter healthcare providers from practicing consistent hand hygiene, such as:

  • Skin irritation caused by cleaning agents
  • Inaccessibility to hygiene products/supplies
  • Interference with healthcare provider-patient relationships
  • Priority of caring for patients over hand washing
  • Understaffing or high workloads
  • Lack of definitive scientific evidence to support the benefits of increased hand hygiene practices

How to Protect Loved Ones from Poor Hygiene Practices

Germs and bacteria spread rapidly in healthcare or long-term care settings, especially when individuals therein have certain morbidities, limited mobility, or compromised immune systems.  You can help protect your loved ones by doing the following:

  • Encourage loved ones (patients or nursing home residents) to engage in consistent hand hygiene practices.
  • When visiting loved ones, keep your hands clean and use hand sanitizer or wash hands before and after interacting.
  • If you believe that a caregiver or healthcare provider is not practicing safe hygiene, speak up. Speak with a supervisor about your concerns and document any incidents that are concerning.

If at any time you have concerns about nursing home abuse or negligence, or medical malpractice, it may also be helpful to contact an attorney to discuss your concerns.  Not every incident related to poor hygiene will constitute abuse or neglect, but sometimes even seemingly small errors or omissions can lead to preventable injury or illness.  To learn more, fill out our online form to schedule a free consultation with one of our attorneys.

meagan cline

Written By Meagan Cline

Meagan Cline is a professional legal researcher and writer. She lends her expertise to FNHA and our websites, including Birth Injury Guide and