Border hospital workers will want to wash their hands of this dirty data

Hand sanitising in the major hospitals spiked during the height of the COVID-19 pandemic but at some it has dropped off sharply since.

Compliance with hand hygiene standards varied from hospital to hospital and Albury Wodonga Health's Wodonga campus was bottom of the pile, an analysis by The Border Mail of the most recent public data shows.

Scores for nine regional hospitals, plus the Royal Melbourne Hospital, ranged from 92.2 per cent down to Wodonga's 70.2 per cent in March 2023.

Four of those hospitals came in below the benchmark of 85 per cent:

An Albury Wodonga Health spokesperson said the hospital's non-public data showed strong improvement in the latter half of 2023.

In Ballarat the hand hygiene rate was as high as 91.7 per cent in October 2020 at the height of the pandemic.

A spokesperson for Grampians Health, which runs Ballarat Base Hospital, said it was "deeply committed to upholding the highest standards of hygiene and safety measures".

They said Grampians Health had brought in "stringent" safety and hygiene measures during COVID to "successfully contain cross contamination".

"We continue to have several procedures in place to evaluate and ensure that our infection prevention and control procedures meet the highest standards," the spokesperson said.

But the data also shows which types of hospital employees clean their hands most at the right moments.

Dental assistants and dentists state-wide topped the charts at 93.9 per cent and 89 per cent respectively. Nurses and midwives were similar to dentists.

Domestic staff, who work in kitchens and deliver meals, had the lowest compliance at 78.6 per cent, just below doctors at 78.9 per cent.

Hand hygiene data is compiled by the Australian Commission on Safety and Quality in Health Care to keep hand washing rates high and hospital-acquired infection rates low.

The data is collected by specialist "hand hygiene auditors" who monitor their colleagues and record whether they clean their hands at specific key "moments", like before or after touching a patient.

Every four months a hospital gets a percentage score showing how frequently its staff clean their hands.

In March 2023 Latrobe Regional Hospital came in at exactly 85 per cent, although it dropped to 51.8 per cent in October 2020.

Shepparton (88.3 per cent), Mildura (91.1 per cent), Wangaratta (91.8 per cent), and Warrnambool (92.2 per cent) hospitals were all above the benchmark.

Wodonga Hospital suffered a big drop in hand hygiene from 95.5 per cent in March 2020 to 70.2 per cent three years later.

An Albury Wodonga Health spokesperson "acknowledged" the "concerning decline", but said its non-public data showed staff hand cleaning had improved through 2023, reaching 78.3 per cent by the end of the year.

They said the incomplete early data for 2024 was even better, at 88.5 per cent.

Controlling bacteria in a hospital was seriously important, Associate Professor Deb Friedman, director of VICNISS which coordinates the Victorian hand hygiene program, said.

"Everyone in a hospital - even if they're not in there with an infection - is carrying bacteria," she said.

"They carry bacteria on their skin, they carry bacteria in their respiratory tract, and they carry bacteria in their gastrointestinal tract."

Humans are covered with bacteria, inside and out, and most of the time this isn't an issue.

But in a hospital the risks were magnified, Professor Friedman said.

"There are many people in a hospital, all with their own bacteria - patients, visitors, staff. There are also people who are there because they already have infections: people with wounds, for example.

"People in hospitals are already sicker than average, which means they're more vulnerable, and they've had more exposure to antibiotics and, therefore, carry more bacteria that are resistant to antibiotics," she said.

Better to avoid infection in the first place.

In a hospital the most common way for bacteria to pass from person to person is on the hands of healthcare workers.

That's where the auditors come in.

Auditors are staff from within the hospital specifically tasked with policing hand hygiene.

"Usually they're standing there on an iPad; it's pretty transparent," said VICNISS infection prevention and control coordinator Donna Taylor.

"Nine times out of 10 they will tell people what they're doing."

And what happened when a nurse or doctor failed to clean their hands?

"Most of the time the auditor will give feedback at the time. That's what they're trained to do," Ms Taylor said.

"The staff are pretty understanding. They know the auditing is mandated."