Hand Washing Non-Compliance in Australian Hospitals: What Are the Costs?

hand wash

Healthcare workers have heard enough about the importance of hand hygiene during their professional career.

The link between not washing hands and hospital-acquired infections (HAIs) has been known for more than 150 years.

Yet hand washing compliance rates are nowhere near that general awareness benchmark.

Australian hospitals report an average of 200,000 HAIs yearly. While it’s estimated 1 in 10 hospital admissions are affected each year. And this translates into 2 million additional hospital days.

The implications? It’s not only extended hospital stays. A need for additional treatment and diagnostics arises – and this pushes up the costs. But it gets worse. HAIs have terrible health implications for patients and hospital staff.

This is mostly preventable. But what you need are good infection control procedures. And hand hygiene compliance strategies that are constantly improved and optimised.

The Australian National Safety and Quality Health Service Standards requires hospitals to review infection control measures periodically in order to minimise the risk of infections.

The costs are high and it’s in healthcare facilities’ best interest to put safety before everything else. Now, let’s take a closer look at the costs of hand washing non-compliance in hospitals as well as some potential remedies for it.

What Will You Learn From This Article?

What Percentage of Healthcare Workers Do Not Wash Their Hands Before Examining Patients in Australia?

What Are The Costs of Hand Washing Non-Compliance in Australian Hospitals?

What Causes Hand Hygiene Non-Compliance in Hospitals?

What Are Some of the Remedies for Hand Hygiene Non-Compliance in Australian Hospitals?

Rise to the Hand Hygiene Challenge

What Percentage of Healthcare Workers Do Not Wash Their Hands Before Examining Patients in Australia?

Frontline workers are well-aware hand hygiene is compulsory in a hospital setting. But how many of them do comply?

Statistics warn us that only 67% of Australian medical staff wash their hands before making hand contact with a patient. The numbers dip further with results after contact with a patient’s surroundings.

Hand Hygiene Australia (HHA) is the national program that measures compliance in hospitals in Australia. Its 2018 report shows hand washing performance results of 1063 organisations (959 hospitals).

Below is the general HHA compliance overview for 2018.

But there’s more to it.

The University of NSW study reveals such results may not be reliable due to the Hawthorne’s effect. A phenomenon marking the change in behavioural patterns when people are being observed.

Audits may prove satisfactory, but the results seem to dwindle after an audit cycle is completed. The study reports hand hygiene compliance rates plummeted from 94% to 30% once human auditors weren’t present anymore.

What Are The Costs of Hand Washing Non-Compliance in Australian Hospitals?

Not complying with the professional hand washing standard comes at a price. Hospitals should seriously consider the scope of negative outcomes associated with HAIs in the clinical practice.

But you may be wondering what those costs are. So, here we go.

Costs to the Australian Economy

Health costs are becoming a huge drain on the Australian economy. This is mainly due to obesity and mental health problems that have been recently on the rise. But all this has increased Australian health expenditures to up to $40 billion quarterly.

To narrow it down, estimated costs of surgical site infections can reach up to $268 million per year. While the total annual health care costs of bloodstream infections can rise as high as $686 million yearly.

Risks to Hospital Patients’ Health

HAIs are equally found in complex and urgent care centres as they are in day-case treatment and acute-care hospitals. Germs are carried on hands and transferred by medical professionals from one patient to another.

So, patients should be protected during the course of receiving their hospital treatment. And different management approaches should be tested to break the chain of contamination.

The most common HAIs are the following:

HAIs are the number one cause of the most common hospital complications. What unsettles the healthcare community is that a growing number of these infections are caused by multidrug-resistant organisms (MDROs).

But how do you deal with the rise of HAIs each year and an increase of MDROs? Nothing beats the continual investment in infection prevention and control which includes:

  • Barrier precautions
  • Screening of high-risk patients
  • An effective hand hygiene promotion program
  • High hospital hygiene standards
  • Surveillance and reporting
infographic sepsis

Image from www.cdc.gov

Risks to Healthcare Workers’ Health

It’s critical medical staff are educated about the risks of acquiring HAIs. This is especially important for emergency care and intensive care unit workers. The potential risks of acquiring HAIs in these settings are the most imminent.

Medical staff should be aware they’re exposed to risks of acquiring infections such as Hepatitis C (HCV) or Human Immunodeficiency Virus (HIV) while performing their medical duties.

They should also be informed about the pathways of transmission of these and other HAIs. Some of them are transmissions through:

  • Blood and body fluids that linger on equipment and can be absorbed by skin or mucosa
  • Lung penetration of HAIs through the air
  • Close contact with the patient
  • Inhaling infected droplets
  • Needlestick injuries

So, good hand washing compliance plays a major role not only in terms of patient safety. It also creates conditions for a safer workplace for your healthcare staff. Other standard precautions against transmission of HAIs include wearing:

  • Gloves
  • Protective mask
  • Protective eyewear
clean hand

Image from www.cdc.gov

Million Dollar Damages to a Hospital Budget

It remains difficult to parse out a single act of hygiene negligence and prove hospital’s culpability. Therefore, there’s a certain amount of complacency within hospital organisations.

But know this. Hospitals are still legally liable for protecting patients against life-threatening infections.

And audits are more strict than ever. While, if the breach is successfully proven, medical negligence compensations can go through the roof.

Medical practice has seen cases settling with damages worth millions of dollars. And the lawsuits are on the rise. So, what follows are a few examples to prove the point.

Example 1:

A 2015 case of a tuberculosis outbreak in Ontario, Canada where 400 patients were affected was resolved in a generous settlement. The hospital paid out a $1.7 million in compensation.

Example 2:

A hospital in Missouri, USA was penalised for an IV transmitted infection to a 69-year-old patient after suffering a heart attack. The hospital was obliged to pay a $2.58 million worth of damages.

What Causes Hand Hygiene Non-Compliance in Hospitals?

Still, have you wondered why the statistics are the way they are? What may be the reasons behind the lack of adherence?

Understanding non-compliance with hand hygiene practices helps you fine-tune your improvement strategies. Now, below are some of the most common reasons healthcare professionals list for not adhering to good hand washing practices.

  • A healthcare worker forgot or was being distracted
  • Empty soap dispensers at the sink and no hand rub available at the point of patient care
  • Frequent need to enter or exit the room when sharing equipment or discharging and admitting patients
  • Skin irritations due to the frequent use of hand washing products
  • A misconception that wearing gloves implies there’s no need for hand washing
  • A belief that the hospital protocol requires excessive hand cleaning

What Are Some of the Remedies for Hand Hygiene Non-Compliance in Australian Hospitals?


When you consider the costs, investing in hand hygiene seems perfectly worthwhile. But how to devise a functional hand hygiene program? Especially when you’ve been cornered and defeated by barriers you’ve been witnessing in your everyday practice.

Pretty much every hospital administration has been there. But, there are some strategies that prove effective in practice.

Hand Hygiene Australia offers support, systems and education materials for implementation of the National Hand Hygiene Initiative. The initiative is based on the WHO ‘My 5 Moments for Hand Hygiene’ which has been proven to help reduce the numbers of HAIs in hospitals.

The program suggests a multimodal system of hygiene management to be implemented across the organisation structure.

It is tried and tested in different geographical and income settings and suggests the following implementation steps:

  • Create an organisation-wide hand hygiene safety culture. Include all levels of your organisation structure, from individual healthcare workers to senior hospital managers.
  • Invest in infrastructure that makes hand washing easy and convenient. Make hand washing facilities such as soap dispensers and alcohol-based hand rubs accessible in patient care areas.
  • Promote hand washing compliance by including visual reminders such as hand washing posters.
  • Educate and train your staff.
  • Keep track of your staff’s hand hygiene practices in order to identify areas of improvement. Then offer active performance feedback, strengthen leadership and reward positive behaviours.

Rise to the Hand Hygiene Challenge

Now, we’ve looked at the costs, causes and remedies of hand washing non-adherence that can steer you towards a better and more realistic hand washing compliance program.

The simple truth is you won’t be able to gain control over HAIs until you hit the nail on the head. And what’s worse than not having enough control over factors that can endanger human lives and put your hospital at risk?

Only continuous efforts can make the difference. And a little bit of help from the outside can make it much easier for you.

Fresh & Clean can help you streamline your hospital hygiene workload by outsourcing your hygiene services.

But it’s not only that we’ll step in and help you handle your washroom supplies. We’ve made sure to profile our company as a one-stop place for hygiene in healthcare.

With us, you’ll have extensive support establishment-wise. We can cover you with our diverse rental programs, bringing professional hospital workwear, WH&S compliant first aid kits and clinical disposal bins right at your door.

Contact Fresh & Clean now and we’ll tailor our services to your specific needs.

Disclaimer: The information presented is not legal advice, is not to be acted on as such, may not be current and is subject to change without notice.

Photo courtesy of Pixabay by offthelefteye