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February 25, 2021

Tweed Hospital scores a fail on hand hygiene

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Northern NSW Local Health District (LHD) has refuted claims that Tweed Hospital is a stand-out failure when it comes to doctors’ hand hygiene.

Concerns about compliance to hand hygiene protocols in north coast hospitals first surfaced several years ago when the Myhospitals website first began publishing results on hospital acquired infections – and the region scored poorly.

Since then, pump packs of antibacterial hand cleaner have popped up at patient bedsides and even next to lifts in hospitals around the region.

But it seems that doctors still don’t use them on a regular basis.

A recent report on the subject published in the Australian Medical Journal says not enough is being done to tackle the resistance of doctors to ensuring they do not pass on bugs while inspecting patients in hospitals.

The article’s authors say that ‘posting a national unadjusted average hand hygiene compliance rate on a public website conceals the fact that most hospitals and medical staff are performing below the national hand hygiene compliance threshold.’

According to the report, in NSW the best performing hospital was Tamworth Base, with 87 per cent compliance, while the worst was The Tweed, with only 63 per cent.

The benchmark minimum is 70 per cent.

And it is doctors who appear to be largely to blame, with nurses and other staff having taken on the hand hygiene message better, the report states.

One of the authors, professor Mary-Louise McLaws, told the Sydney Morning Herald this week that the real rates of compliance could be even lower, as the audits involved physical supervision.

‘It is quite remarkable given that the healthcare worker can see the auditor [that] they still aren’t getting their hand hygiene rates up really high,’ the professor said.

‘I think it must be the only patient safety measure where they just watch a doctor … [do the wrong thing] and let them carry on,’ she added.

But Northern NSW LHD chief Wayne Jones has dismissed the claims, saying the new protocols are much tougher than those previously in place.

‘I don’t think Tweed Hospital can be isolated as having problems. I think historically there was – not reluctance – but there was a need to change the culture of our clinicians in ensuring their hand hygiene,’ he told ABC North Coast this morning.

‘It’s also about recognizing that the hand hygiene tool that’s being used is a five-step process so it’s increased the benchmark significantly from what was a two-step program.

‘So it’s about getting people to recognize that they need to be even more vigilant than they have in the past.’

But the program manager of healthcare-acquired infection at the Clinical Excellence Commission, Paul Smollen, told SMH there was ‘no way to spin’ the poor practices among doctors prior to touching a patient.

The report’s authors concluded that, ‘given the poor compliance after four years of auditing to capture non-compliance, we must shift our focus to providing medical staff with immediate feedback and move to improving a single hand hygiene indication at a time, starting with before touching a patient.’


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