Evaluation of patient participation in a patient empowerment initiative to improve hand hygiene practices in a Veterans Affairs medical center

BackgroundIn patient empowerment initiatives, patients are encouraged to ask caregivers if they have washed their hands. However, relatively little is known about the willingness of patients to participate in such initiatives.MethodsPatients were presented with a “Partners in Your Care” script asking them to remind health care workers to wash their hands, and follow-up interviews were conducted. Compliance was reassessed using a modified script in which patients were asked to thank health care workers for washing and/or to display a sign stating “Thanks for Washing.”ResultsOf the 193 patients presented with the initial script, 5 (3%) stated that they had reminded health care workers to wash, and 15 (8%) had not commented despite observing health care workers failing to wash in their presence. Of the 38 patients given the modified script instructing them to thank health care workers for washing, 17 (45%) reported mentioning hand hygiene to health care workers (13 of whom thanked the caregivers), and 6 (16%) did not comment despite observing health care workers failing to wash in their presence. Most patients displayed a sign thanking caregivers for washing; however, no patients were observed to comment on hand hygiene during physician work rounds, and only 2 of 30 (7%) nurses on the study wards reported being thanked for washing.ConclusionIn this Veterans Affairs hospital, patients were unlikely to remind health care workers to wash their hands. Patient empowerment initiatives may be more effective if patients are encouraged to provide positive reinforcement and/or display prompting visual reminders.