Infection prevention practices centred on hand hygiene protocols can save lives across all healthcare facilities, not just hospital settings.

This includes nursing homes, according to a new study published in the February issue of the American Journal of Infection Control (AJIC), the journal of the Association for Professionals in Infection Control and Epidemiology (APIC).

Researchers found that incorporating consistent measures that prompt staff, residents, and visitors to wash hands can lower mortality and antibiotic prescription rates, and increase overall hand cleaner use. This study is among the first to assess practices outside of the hospital setting through a randomised controlled trial.

The hand hygiene program, which targeted nursing home staff, residents, visitors, and outside care providers, included facilitated access to hand-rub solution using pocket-sized containers and new dispensers; a campaign to promote it with posters and event organisation; and forming local work groups in each home to focus on guidelines and staff education. Staff were given online quizzes at the program’s culmination; those who did not score high enough were invited to redo the education portion at a later date.

“Hand hygiene protocols have traditionally focused on acute care settings. Our study is changing this narrative, underscoring that we can take a proven intervention practice and make it work outside of the hospital space, by specifically adapting it to long-term settings,” said Laura Temime, the study’s lead author and a professor at the Conservatoire National des Arts et Métiers.

Nursing homes are known sites of infection prevalence. In the US alone, they will report some 3 million infections per year, accounting for the largest share of NH mortality and up to $1 billion in added annual healthcare costs. The death rate due to infections in NH is estimated at 0.6 per 1,000 resident days.

Globally, compliance with hand hygiene recommendations remains low among nursing home staff - tallying in at 14.7 percent in Canada, 17 percent in Italy and 11.3 percent in Taiwan.