Being caught in the act is typically a shameful experience, but in this case, action was celebrated and

non-action was a cause for alarm. What the physician observed is something that regrettably is repeated all too often within the healthcare environment and warrants revisiting over and over again.

In 2008, Gerald Hickson, MD, dressed in casual clothes, observed healthcare workers as they came in to care for his wife after double-knee replacement surgery. Vigilantly, he counted the number of times hands were cleansed in preparation or at the conclusion of caring for his wife. Employees who didn’t soap up were politely reminded to do so, and those who remembered were rewarded with his acknowledgment and sincere “thank you.” The number of employees caught in the hand washing act: 32; the number of opportunities: 92. You may wonder if that would happen today, and likely, the numbers would be lower because of Hickson and others at Vanderbilt University who took these dismal figures to the top. 

What filtered down was an effective process for improving hand washing compliance and reducing infection hospital wide. Many of the safeguards we use today are a result of Vanderbilt’s experience of increasing hand-cleansing compliance to 97%. Hand sanitizer stations (for employees and visitors) were installed outside of every patient room. Compliance monitors (assigned staff) were on duty to observe and remind employees to wash up. Competition boards and monetary incentives, natural human motivators, were also instituted. Above all, empowering all employees with permission and power to speak up and remind each other of this vital lifesaving measure helped Vanderbilt meet the goal of improved patient care. 

On a hectic busy workday, there are probably umpteen times when a nurse could and should protect patients by cleansing his or her hands; and it’s not just patients who need protection from our germ-laden world. Everyone should be squirting the soap or hand sanitizer (when appropriate). Make time to wash, and when you catch others in the act, celebrate.