Hand hygiene 'too complex' for doctors

Doctors at most public hospitals are failing to follow national hand hygiene guidelines, a new study shows.

This is because the current five-step approach is too complex, says Professor Mary-Louise McLaws, an infectious diseases expert at the University of New South Wales.

Her study focused on how regularly health workers wash their hands before seeing a patient, which is the first hand-hygiene opportunity in the five-step plan adopted in Australia in 2009.

The approach should be simplified to focus on washing hands before and after seeing each patient, says Prof McLaws, who has published a report in the Medical Journal of Australia.

Human instinct will take care of other protocols, such as washing after coming into contact with bodily fluids.

"We need to simplify it. Five behaviour changes were thrown at the doctors and nurses all at once.

"The nurses got it. They are exemplary compared with doctors. But they work in teams and support each other."

Prof McLaws says the way compliance is audited also needs an overhaul. Auditors and other health workers should be empowered to intervene politely if they see a colleague breaching hygiene guidelines.

"We have neglected to help doctors change their behaviour."

They found doctors consistently performed below the national 70 per cent compliance threshold.

This increases the risk of passing on germs from one patient to another, says Prof McLaws.

Nurses' compliance was above the threshold.

But since there are more nurses than doctors this makes the national performance look better than it is, she says.