Hand hygiene: improved standards and practice for hospital care.
OBJECTIVE
To review the most recently published literature on hand hygiene practices in healthcare settings.


RESULTS
Adherence with recommendations for hand hygiene remains low, but key factors of noncompliance have been identified and corrective actions proposed. Current guidelines recommend the use of alcohol-based handrub formulations as the new standard of care, thus requiring a system change in most hospitals. In addition, healthcare worker education and motivation are obviously important to modify hand hygiene behavior and must be part of multimodal strategies to enhance compliance in hospitals. Compliance improvement is associated with reduced infection rates and resistance spread. Handrub application according to recommended practices is an alternative to conventional surgical handscrubbing with antiseptic soap and water for surgical hand preparation.


CONCLUSIONS
System change must be addressed in most hospitals where alcohol-based handrubbing has not become a standard of care. Strategies to improve hand hygiene compliance must be multimodal and include staff education and motivation, the use of performance indicators, and hospital management support. Successful campaigns will result in reduced infection rates, antimicrobial resistance spread, and enhance patient safety.
Pittet
Didier
D
Infection Control Program, University of Geneva Hospitals, Switzerland. didier.pittet@hcuge.ch
D019983:Guideline Adherence; D006235:Hand Disinfection / Q000379:methods* / Q000592:standards*; D006761:Hospitals / Q000592:standards*; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000592:standards*