Hospital Workers Wash Hands Less at End of Shift, Study Finds

Hospital Workers Wash Hands Less at End of Shift, Study Finds

Hospital Workers Wash Hands Less at End of Shift, Study Finds

New research suggests mental fatigue may be responsible for lapse in hygiene

SOURCE: American Psychological Association, news release, Nov. 10, 2014

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- Health workers in hospitals wash their hands less often as they near the end of their shift, a new study has found.

And this lapse -- likely due to mental fatigue -- could contribute to hundreds of thousands of patient infections a year in the United States, the researchers noted.

The study examined three years of hand-washing data from more than 4,000 caregivers at 35 U.S. hospitals. The researchers found that compliance with hand-washing protocols fell by an average of 8.7 percent from the beginning to the end of a typical 12-hour shift.

Increased work demands were associated with greater declines in hand-washing compliance rates, according to the study.

Sixty-five percent of the study participants were nurses. Another 12 percent were care technicians, the study reported. Just 4 percent of those involved in the study were physicians, and the remainder included other types of health workers.

"Just as the repeated exercise of muscles leads to physical fatigue, repeated use of executive resources (cognitive resources that allow people to control their behaviors, desires and emotions) produces a decline in an individual's self-regulatory capacity," wrote Hengchen Dai, a Ph.D. candidate at the University of Pennsylvania, and colleagues.

The more time that hospital workers had off between shifts, the more closely they followed hand-washing protocols, according to the study published online recently in the Journal of Applied Psychology.

"Demanding jobs have the potential to energize employees, but the pressure may make them focus more on maintaining performance on their primary tasks [e.g., patient assessment, medication distribution], particularly when they are fatigued," Dai said in a news release from the American Psychological Association.

"For hospital caregivers, hand-washing may be viewed as a lower-priority task and thus it appears compliance with hand hygiene guidelines suffers as the workday progresses," she explained.

Using data from previous studies, Dai and her colleagues extended their findings to all hospitals in the United States and estimated that lower hand-washing compliance among hospital workers as their shifts progress could lead to an additional 600,000 patient infections a year at a cost of $12.5 billion annually.

"We believe ours is the first study investigating whether accumulated work demands can affect rule compliance over the course of a single workday, as opposed to over weeks, months or years," study co-author Katherine Milkman said in the news release.

"We think this line of research could be applied to other types of workplace compliance, such as ethics standards in banking, safe driving behaviors in trucking, and safety standards in manufacturing," she added.

More information

The National Patient Safety Foundation outlines what you can do to prevent infections in the hospital.
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