As nurses, we all know the importance of handwashing. We understand that germs can spread disease, and that hand hygiene can help defend against it. But still, 78 percent of all healthcare professionals tested in a recent study presented at a conference of the Association for Professionals in Infection Control and Epidemiology (APIC) didn’t wash up to the standards of the World Health Organization’s guidelines for reducing the risk of spreading infection to patients. So, why so many slackers?

Perhaps sinks or hand sanitizer dispensers aren’t always in the most convenient locations in hospitals. And if they are conveniently located, there might not always be soap or sanitizing gel in those dispensers. Or maybe it’s just that we’re rushing from one emergency or critical situation to the next, and taking time to stop and wash our hands consistently doesn’t get prioritized. Or simply because, given those same circumstances, we merely forget.

It seems so obvious, yet the importance of handwashing wasn’t always known. In 1847, a physician working in a Viennese maternity hospital with two separate clinics, one run by physicians and one run by midwives, discovered that babies delivered by physicians had nearly triple the infant mortality as babies delivered by midwives. The reason was that the doctors coming into the hospital to deliver babies had just finished up duties in the autopsy ward, thereby infecting mother and child with numerous germs acquired from their deceased patients. Once doctors were instructed to wash their hands with an antiseptic solution before delivering babies, the mortality rate plummeted.

Getting Nurses to Wash Their Hands
Solutions to promote more frequent handwashing can run the gamut for many hospitals. Implementing one of several newfangled, automated hand hygiene monitoring devices such as video-monitored direct observation systems, electronic dispenser counters, and automated hand hygiene monitoring networks can work for some. And while there is empirical proof that these types of monitoring systems work, with the budgetary constraints many hospitals face, adoption can be cost-prohibitive and therefore not an option.

While there is no universal solution, many hospitals have taken steps to further encourage handwashing by investing in alcohol-based hand rub solutions (significantly more efficient in reducing hand contamination than antiseptic soaps), both by installing wall-mounted dispensers and by providing individual containers for each healthcare worker. Changing posted messages around the hospital from, “Wash Your Hands to Protect Yourself” to “Wash Your Hands to Protect Your Patients" can be helpful, along with peer pressure and personal incentives like drawings for free monthly manicures (yes, we all know the toll that constant handwashing can have on our skin and nails).
 
New incentives
It’s apparent that handwashing keeps us healthier, but what isn’t noticeable is the additional, subtle psychological effect handwashing has on us all as well. The Dalai Lama tells us, “as human beings we all want to be happy and free from misery… and we have learned that the key to happiness is inner peace.” So, what if you could achieve inner peace and happiness through the simplest of daily activities – like handwashing?

A study from the University of Cologne in Germany examined how the act of washing one’s hands can positively affect us after a bad experience or stressful event while also making us feel more optimistic after recent failure. Earlier research from the University of Michigan also found that handwashing can be physically and emotionally cleansing, suggesting that this simple act can make us feel more comfortable about decisions we’ve made or actions we’ve taken.

Personally, when I finish a workout at the gym, the first thing I do is wash my hands. Somehow, this simple ritual of washing my hands afterwards provides a sense of finality and accomplishment. The workout ritual, however, is far more complex (at least for me).

The act of seeking cleanliness has two distinct meanings to us humans. The first is the obvious physical hygiene benefits. The second is more psychological in nature. Psychological studies have shown that the simple act of washing one’s hands can help you feel more optimistic, less doubtful, and even a bit morally superior – as “clean” people have been found to be more judgmental towards other people’s bad behavior. Think Lady Macbeth.

So, maybe now as we endeavor to wash our hands for the hundredth time today, recalling the Nightingale Pledge and our duty to protect our patients’ safety, we can also reflect on our own goals for self-improvement, including eating healthier, trying to exercise more, and being kinder to others and to our planet, knowing that this simple act of handwashing might be a more logical path to happiness and inner peace. Or, at least we can tell ourselves that. 

References:
Brun-Buisson, C., Girou, E., Legrand, P., Loyeau, S., Oppein, F., (2002, August 17). Efficacy of
handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial. Retrieved from NCBI, US National Library of Medicine National Institutes of Health  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC117885/
 
Johnson, N., Niles, M. (2016, June 2). Hawthorne Effect in Hand Hygiene Compliance Rates. American
Journal of Infection Control, Volume 44(Issue 6), S28-S29. Retrieved from AJIS
http://www.ajicjournal.org/article/S0196-6553(16)30209-7/pdf
 
Kaspar, K. (2012, April 10). Washing One’s Hands After Failure Enhances Optimism but Hampers Future
Performance. Social Psychological and Personality Science, Volume 4(Issue 1), 69-73.
Retrieved from http://journals.sagepub.com/doi/full/10.1177/1948550612443267#articleCitationDownloadContainer
 
Psyblog (n.d.). 6 Purely Psychological Effects of Washing Your Hands. Retrieved from
http://www.spring.org.uk/2013/10/6-purely-psychological-effects-of-washing-your-hands.php