University of Wisconsin–Madison Medical College of Wisconsin

Hand Hygiene Among Health Care Workers: Is Educating Patients and Families a Feasible Way to Increase Rates?

Marvin J. Bittner, MD; Jared M. Routh, MD; Matthew D. Folchert, MD; Nicholas E. Woessner; Sean J. Kennedy, BS; Chase C. Parks, BS

WMJ. 2019;118(1):79-83

Download full text pdf.


Background: The Centers for Disease Control and Prevention has recommended teaching patients to remind health care workers to disinfect their hands. However, cognitive impairment among patients may hamper such efforts.

Methods: The St. Louis University Mental Status (SLUMS) Examination was administered to randomly selected inpatients at the Omaha VA Medical Center in Omaha, Nebraska. We asked patients and their families about attitudes toward reminding health care workers to disinfect their hands: willingness, feeling comfortable, and feeling responsible.

Results: Of 143 patients, 94 completed SLUMS; 9 had normal mental status and appropriate attitudes. Overall, 16 encounters involved patients or family who were well-suited for giving reminders.

Conclusion: Programs to encourage hospitalized adults to remind staff to perform hand hygiene may encounter barriers related to cognitive impairment and attitudes.

Author Affiliations: Nebraska-Western Iowa Veterans Affairs Health Care System, Omaha, Neb (Bittner, Routh, Folchert, Woessner, Kennedy, Parks); Division of Infectious Diseases, Department of Internal Medicine, Creighton University School of Medicine, Omaha, Neb (Bittner); Department of Internal Medicine, University of Iowa, Iowa City, Iowa (Routh); Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Wash (Folchert); University of Iowa Carver College of Medicine, Iowa City, Iowa (Kennedy).
Corresponding Author: Marvin J. Bittner, Nebraska-Western Iowa Veterans Affairs Health Care System, 4101 Woolworth Ave (111D), Omaha, NE 68105-1873; phone 402.995.3602; fax: 402.977.5601; e-mail
Acknowledgement: This research was presented in part April 2, 2011 at the 21st Annual Scientific Meeting of the Society for Healthcare Epidemiology of America; Dallas, Texas; Poster 125.
Funding/Support: None declared.
Financial Disclosures: None declared.
Share WMJ