Hand hygiene should be strictly followed by one and all, but the case is even stronger when it comes to doctors. According to a new study, however, medical staff becomes negligent sometimes and falls victim to the Hawthorne Effect.

A team of researchers at the Santa Clara Valley Medical Center (SCVMC), San Jose, explained that the said effect occurs when people change their behavior if they know someone is keeping an eye on them.

The findings showed that hand hygiene practice among doctors differed when they know they are being evaluated than when not. Researchers at SCVMC sent two types of investigators to evaluate hand hygiene: Infection Prevention (IP) nurses, and high-school and college-aged volunteers.

Over the course of the study, Maricris Niles, an infection prevention analyst at SCVMC, noticed that the groups were differing in their opinion. The IP nurses – considered as the hygiene patrol in hospitals – noticed increased compliance rates.

However, the Hawthorne Effect was found upon further investigation. According to Lisa Hansford, one of the recognizable IP nurses at SCVMC, when nurses or doctors knew someone in authority is supervising, they would follow proper procedure of hand hygiene.

But if they thought no one was watching, they would skip using alcohol. IP nurses observed the hygiene compliance rate was around 57 percent, whereas in the case of hospital volunteers, it was a much lower 22 percent.

It’s a massive gap that shocked the research team. Nancy Johnson, infection prevention manager at SCVMC, said that the medical staff might get so caught up in the work that they need someone to remind them to follow hand hygiene.

To make sure that the high-school and college-aged volunteers performed viable assessments, they were trained beforehand; because they were not consistently recognized as authority figures by hospital staff, they were able to provide more accurate data on hand hygiene.

Researchers explained they found “a very consistent trend that our Infection Prevention nurses were seeing something different than what volunteers were seeing.” The nurses and providers who did not use alcohol to wash their hands did so as soon as they would recognize the hygiene auditors.

Because the phenomenon is not new and the problem is more spread, the team at SCVMC has launched a series of interventions to drive the medical staff’ compliance rates higher.
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