title: The influence of nurse cohorting on hand hygiene effectiveness.
abstract: BACKGROUND
  Direct contact between health care staff and patients is generally considered to be the primary route by which most exogenously-acquired infections spread within and between wards. Handwashing is therefore perceived to be the single most important infection control measure that can be adopted, with the continuing high infection rates generally attributed to poor hand hygiene compliance.
  
  
  METHODS
  Through the use of simple mathematical models, this paper demonstrates that under conditions of high patient occupancy or understaffing, handwashing alone is unlikely to prevent the transmission of infection.
  
  
  CONCLUSIONS
  The study demonstrates that applying strict nurse cohorting in combination with good hygiene practice is likely to be a more effective method of reducing transmission of infection in hospitals.
authors.affiliation: School of Engineering, Design and Technology, University of Bradford, Bradford, West Yorkshire, UK. c.b.beggs@bradford.ac.uk
authors.forename: Clive B
authors.initials: CB
authors.lastname: Beggs
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Noakes
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Shepherd
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Kerr
authors.forename: P Andrew
authors.initials: PA
authors.lastname: Sleigh
authors.forename: Katherine
authors.initials: K
authors.lastname: Banfield
mesh_terms: D001291:Attitude of Health Personnel; D050936:Basic Reproduction Number / Q000517:prevention & control / Q000706:statistics & numerical data; D001509:Bed Occupancy / Q000706:statistics & numerical data; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D003441:Crowding; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006235:Hand Disinfection / Q000592:standards; D006301:Health Services Needs and Demand; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D015233:Models, Statistical; D015401:Nursing Administration Research; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration* / Q000523:psychology; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D011336:Probability; D018570:Risk Assessment; D012307:Risk Factors; D016526:Workload / Q000706:statistics & numerical data