Innovative new tool makes good hand hygiene a game anyone can play

A new game, designed to remind health professionals and students about the importance of building good hand hygiene habits, has lessons for us all.

The COVID-19 pandemic raised awareness of the importance of hand hygiene like never before. Most of us now have relaxed our handwashing regime, but good hand hygiene remains essential in healthcare settings to prevent the spread of infection. 

My 5 Moments for Hand Hygiene, a video game available free for anyone to play on the World Health Organisation website, sees players take on the role of a health professional working in the International Alien Hospital in the year 2224. Earth is at peril from a mysterious time-unravelling, and the only cure is to take care of a batch of aliens who are highly sensitive to germs.

The game is based around the five moments at which health professionals should sanitise their hands:

  • Before touching a patient
  • Before any procedure
  • Immediately after a procedure or exposure to bodily fluids
  • After touching a patient 
  • After touching a patient’s surroundings

According to the most recent audit from the Australian Commission on Safety and Quality in Health Care (ACHQSC), Australia is meeting the benchmark of 80 percent for observing hand hygiene in health care settings, although nurses tend to be more observant than doctors. 

Some experts have raised doubts over those figures, however, with one US study suggesting the compliance rate in American hospitals was closer to 30 percent.

The ACHQSC says knowing when and how to perform hand hygiene is vital for everyone working in health care – including nurses, doctors, allied health, aged care workers, cleaners and support staff. 

It isn’t just about COVID. Effective hand hygiene reduces the transmission of microorganisms such as MRSA that cause infections in hospitals. These healthcare-associated infections affect more than 81,000 Australians each year.  

In a video released by ACHQSC, Dr Clare Skinner, former president of the Australasian College for Emergency Medicine said there was always time, even in moments of crisis, for good hygiene.

“Healthcare-associated infections, caused by insufficient hand hygiene are one of the most common complications affecting patients in hospital and can lead to adverse outcomes,” Dr Skinner said.

Whiteley chairman and one of the world’s most respected infection-prevention experts, Dr Greg Whiteley said a range of factors get in the way of healthcare workers following hand hygiene protocol.

“Some of its habitual, some of it is urgency, some of it is just a lack of perceived need,” Whiteley said.

“People don’t perceive the need to do hand hygiene. They perceive the environment as clean, they perceive their hands are clean, and they think, oh, I haven’t touched anything.”

Whiteley said evidence showed after touching contaminated surfaces, germs could stay on hands for up to 19 subsequent touches. This was particularly an issue in intensive care units, where 90 percent of all surfaces were shown to be contaminated. It was also potentially as much an issue for cleaning staff as it was for health professionals, Whiteley said.

“Again, data we’ve published shows that the 19 touch rule applies even if you’ve got gloves on. And if you’ve got wet gloves on, because you’ve been doing some cleaning, you’re likely to have 10 times the number of bugs that you would have if you had dry hands.”

Anyone entering a healthcare setting, be they healthcare worker or visitor, would benefit from observing the five moments and using TGA-approved hand sanitiser. Whiteley said everyone had something to learn about good hand hygiene.

“Here’s the rule of thumb for you and your family when you go into hospital — don’t touch anything. And wash your hands regularly!”

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