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Hand Hygiene

Key Facts

  • Good hand hygiene – washing hands or using a hand sanitizing gel – is the number one way to prevent the spread of germs.
  • Health care workers should wash their hands before and after caring for each patient.
  • Patients, families, and visitors should also practice good hand hygiene. 
washing hands with soap

What is this measure?

Hand hygiene is a top priority at Johns Hopkins Medicine. Hand hygiene means cleaning your hands by either washing them with soap and water, or by using a hand sanitizing gel. Hand hygiene is the number one way to prevent the spread of germs and to prevent infections.

People who are experts in stopping infections work with healthcare providers, patients and families to make sure that they always keep their hands clean. This helps prevent the spread of viruses and bacteria that cause colds, flu and other infections.

At Johns Hopkins Medicine, some employees are trained to watch how well medical staff keep their hands clean. They observe doctors, nurses and other health care workers to see if they wash their hands or use antibacterial gel before entering or leaving a patient’s room.

Johns Hopkins Medicine takes hand hygiene very seriously. More than 65,000 hand hygiene observations are monitored each year. This information is shared with hospital staff and leadership. The information is used to help to continually improve hand hygiene in our health system so that we can provide the safest and best care to all of our patients.

How does Johns Hopkins Medicine perform?

  • The Johns Hopkins Hospital
  • Johns Hopkins Bayview Medical Center
  • Sibley Memorial Hospital
  • Suburban Hospital
  • Howard County General Hospital
Data Source: Johns Hopkins Medicine

*Benchmark Source: Maryland Hospital Hand Hygiene Collaborative goal

Why is it important?

The Centers for Disease Control and Prevention (CDC) says washing hands is one of the most effective ways to prevent the spread of diseases and infections. Germs can live on surfaces for hours and are often passed from person to person through physical contact.

Health care workers come in contact with patients, equipment and other items in patient rooms. In the hospital, there are many opportunities for hand hygiene to help keep our patients safe. Ensuring doctors, nurses and other staff have clean hands is critical to prevent the spread of illness.

The Joint Commission, a health care accreditation organization, says direct observation of staff hand hygiene is the most effective and accurate way to measure hand hygiene compliance.

What is Johns Hopkins Medicine doing to continue to improve?

Johns Hopkins Medicine strives for 100 percent hand hygiene compliance for all health care workers.

Awareness and Education Campaigns

Hopkins Hands is a campaign at every Johns Hopkins Medicine hospital to educate staff on the importance of good hand hygiene. Posters and signs are placed around the hospital as reminders for health care workers, patients and visitors to wash their hands or use a sanitizing gel. Staff and patients are also encouraged to speak up if they notice someone forgot to wash their hands.

Johns Hopkins Medicine also educates staff that may not have direct patient contact, but still play a vital role in infection prevention through good hand hygiene.

Keeping Staff Accountable

We continually use signs and education to remind staff of the importance of hand hygiene. All staff are encouraged to speak up if they see someone who has forgotten to wash their hands.

Every Johns Hopkins Medicine hospital also has employee recognition programs for staff members and units excelling at consistently practicing good hand hygiene. Many of our facilities also have programs in place for direct feedback and coaching for staff members who were observed forgetting to perform hand hygiene.

Frontline Perspective

Hands Safety Team As a bedside nurse in Weinberg, a perioperative unit for oncology patients, Melanie Mallari (fifth from right, front row) and her team were recognized as a top performer in hand hygiene. Mallari credits all of the staff members for their efforts in consistently practicing good hand hygiene habits. 

Melanie Mallari, R.N., B.S.N., M.S.N., C.P.A.N., C.A.P.A.
Nurse Clinician

“On my unit, I take care of patients who have cancer and are undergoing surgery, and their safety is my priority. While they are under my care, it is my responsibility to practice good hand hygiene and hold my other team members accountable to do the same. It’s the most effective way to prevent the spread of infection or disease.

One of the best ways to keep good hand hygiene top of mind is to talk about it among everyone involved in patient care — and often. We share reports of how we are doing with keeping our hands clean in monthly meetings, which repeatedly reminds all of us to make this a standard practice every day.

Buy-in from the doctors and staff is essential. In fact, I often see surgeons and anesthesiologists making the effort to ask, “Where is the Purell bottle by the bedside?” This sends a great message to the other members of the health care team to practice good hand hygiene. Their support causes a ripple effect all the way from the attending physicians to the nurses, staff members and medical students who they are mentoring.

The best part of my job is that I can see the work I’m doing makes a difference in changing the behaviors and habits of the staff members and providers. Most importantly, by keeping our hands clean, we are showing a commitment to our patients to take the best possible care of them and help them get better.” 

How can patients and families support safety?

Patients and families are encouraged in the patient handbook to speak up and ask health care providers if they washed their hands prior to entering the patient room.

Patients and visitors should wash their own hands often, including before eating, after using the restroom and after touching any surface in the hospital room. Visitors should also follow any additional infection control measures, such as wearing an isolation gown, put in place by the health care team.

Communicating with Your Health Care Team

Hospital stays and medical treatments can be stressful for patients and families. Communication can be challenging, and it may be difficult to know what questions to ask your health care team. Many resources are available to empower patients to effectively communicate questions and concerns with their doctors, leading to better, safer health care. 

One resource is Doctella, developed in consultation with patient safety physician experts at Johns Hopkins Medicine. The online tool provides patients with specialized checklists of questions to ask their health care team and to-do lists to get organized before a medical procedure, surgery or exam.

Examples of questions from checklists:

  • How soon do you recommend I have this surgery?
  • Will I need anesthesia for this procedure?
  • What are my options for pain medications after surgery?

Patients who want to learn more can visit the Doctella web site to access checklists for surgeries and procedures. Click here.

Additional Resources