Interventions to improve hand hygiene compliance in patient care

Gould DJ, Chudleigh JH, Moralejo D, Drey N

Summary

Patients in hospital are at high risk of developing infections that they did not have before admission. Most health care-associated infection is spread by direct contact, especially via the hands of health workers. Traditionally hand hygiene, such as washing hands before and after seeing patients, has been considered the single most important way of reducing such infections. But compliance with hand hygiene protocols in health workers is poor.

This review sought to establish whether there are effective strategies to improve hand hygiene compliance, whether such strategies are effective over short or longer term, and whether increased compliance reduces health care-associated infections.

There were two studies that assessed the success of campaigns to improve hand hygiene compliance. Both were of low quality and looked at the effects of strategies over very short periods of time (less than six months).

There is not enough evidence to be certain about what strategies improve hand hygiene compliance. "One off" teaching sessions about hand hygiene may not improve hand hygiene, but again there is not enough evidence to be certain. More research is needed.