One-quarter of the seniors in several post-acute care facilities (PACs) in Michigan had at least one antibiotic resistant superbug on their hands when they checked in, according to a new University of Michigan study. This highlights the need for new policies to encourage hand washing among patients.

“With an aging population in the hospitals, patients are going to need assistance in washing hands,” Dr. Lona Mody, lead author of the study, told HCB News. “We have to revise policies to include patient hand hygiene and reward facilities that go an extra mile to achieve consistent effective hand hygiene in their patients.”

A few strains of several infectious bacteria have become resistant to antibiotics because the medication is often overused in many health care settings. Every year superbugs infect over two million people around the world and kill at least 23,000, according to the U.S. Centers for Disease Control and Prevention.

The researchers studied 357 seniors who were sent from a hospital to a PAC facility in southeast Michigan. They found that about 24 percent of them had at least one superbug on their hands when they entered the facility.

The researchers continued to evaluate the patients after two weeks, and then on a monthly basis for up to six months, or until they were discharged. They found that the over time, 34.2 percent of the seniors acquired superbugs on their hands.

After common procedures like hip and knee replacements, seniors often require additional time in a PAC facility for rehabilitation. Nowadays, many of those patients want to be active, so they select facilities that offer group activities and social events.

That can actually contribute to the spread of superbugs, because when people leave their rooms often, they’re more likely to touch the facility’s environment, health care workers and other patients, which puts them at risk of acquiring more superbugs.

Even though the staff is required to wash their hands, it’s not a routine practice for patients. However, the researchers think that new policies and innovations geared toward patients are needed in order to prevent the spread of superbugs.

One strategy that the researchers feel would be helpful is showing the patients the superbugs that could be on their hands by growing them in the lab. People are always surprised when they see how much can grow on their hands and how effectively it can be cleared by washing their hands, said Mody.

Mody and her team developed a toolkit to train staff in PACs on how to control infections, but it could be adapted to serve the patients as well. The toolkit includes educational posters about hand hygiene, education modules and trivia questions about hand hygiene, and an infection preventionist on-site to ensure the availability of hand hygiene products like alcohol gel.

“We need to really study effective methods that patients and families would respond to,” said Mody. “Everyone likes cleanliness. But bringing in patients’ voices will allow us to design most appropriate, likable and suitable tools.”

The results of the research were published in a JAMA Internal Medicine research letter.

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