A growing problem in nursing homes throughout the Nation puts sick and elderly residents at increased risk of contracting deadly infections: Employees are working with dirty hands.

The Centers for Medicare and Medicaid mandate that nursing home employees wash or sanitize their hands at the beginning of each shift, after any direct contact with residents and at the end of each shift in order to cut down on the spread of deadly infectious disease like MRSA and Clostridium difficile in the facilities. But researchers say there is a growing incidence of deficiencies in nursing home hand hygiene.

Inspectors discovered that poor hand hygiene was an issue in fewer than 7.4 percent of nursing homes from 2000 to 2002. By 2009, however, the problem was noted in about 12 percent of facilities.

A study, published in the Journal of Applied Gerontology, attributes the lack of hand hygiene to staffing shortages and low Medicare reimbursement. Adding to the problem are increasing numbers of nursing home residents suffering from dementia and other conditions that require hands-on help for basic hygiene like brushing teeth, changing clothes or using the restroom.