Hand hygiene is the single most important step caregivers can take in preventing hospital-acquired infections, yet research shows that nurses and other caregivers often don't follow recommended guidelines for hand hygiene - and are only in compliance from 30 percent to 48 percent of the time, depending on which study is being cited.

"Nurses often are overworked and get busy and sometimes cut corners in their work. This might mean they 'skip' handwashing because they feel they don't have the time," says Cheryl Wagner, Ph.D., MSN/MBA, RN, associate dean of graduate nursing programs at American Sentinel University.

She points out that many nurses were not initially taught the standard of 'wash when you enter and when you leave' and many other nurses trained before 2000 were just taught to wash as they left each patient's room.

Dr. Wagner says the number one factor contributing to poor handwashing compliance among health care workers is due to short staffing that leads caregivers to think they do not have to spend time on hand hygiene.

Another key factor is poor training or knowledge of the risks. "Most people do not realize how many germs they encounter in patient contacts, both those they pick up in the room and those they bring in," says Dr. Wagner.

She notes that poor understanding of the use of protective gloves is very highly ranked too. "How many times have you seen a person with gloves touch the floor or a dirty dressing and then touch a patient," she adds. "They forget that while they are protected from contamination by the gloves that the outer part of the glove still can contaminate the patient."

Dr. Wagner stresses that most health care workers do not understand the many places that bacteria and deadly infectious agents can hide in a patient's room, dressings, bed clothes, walls and floors.

"Nurses must understand that any contact with any surface in a patient's room requires them to wash their hands and that gloves do not absolve them of the need to wash," she adds.

While infection preventionists have always made efforts to educate staff about the importance of hand hygiene in preventing infection and tracking infections to see if there are causes that they can investigate and prevent though education and training, the stakes have recently gotten higher. Under new Medicare rules, hospitals will no longer be reimbursed for treating certain kinds of hospital-acquired infections that have been deemed preventable.

"The new Medicare rules just increases the infection control nurses' worth exponentially," says Dr. Wagner. "They will be invaluable in educating staff about preventative measures, tracking and obliterating infection issues and carefully orchestrating the care of those patients considered most at risk or the most potentially hazardous."

Dr. Wagner says that nurses with an infection prevention and control specialty will be in high demand.

"Nurses are excellent teachers and role models and have the contacts with patients, other nurses and staff to make the hospital and any acute care area a safer place," she says.

Hospitals that employ nurses with specialized education in the field of infection prevention are just that much more ahead of the competitive curve and addressing patient safety issues.

She notes that hospitals are ranked by their rate of infections and when a nurse with the specialized infection control education decreases their rate of infection, they are going to be that much higher in the rankings.

Nurses interested in planning, implementing, and evaluating infection prevention and control measures should consider making this field their career specialty. As a first step, Dr. Wagner recommends that nurses develop new skills and empower themselves with knowledge through an online RN to MSN degree with a specialization in infection control.

For more information about American Sentinel University's MSN, infection prevention and control specialization, please visit http://www.americansentinel.edu/health-care/m-s-nursing/m-s-nursing-infection-prevention-and-control.