title: Role of hand hygiene in healthcare-associated infection prevention.
abstract: Healthcare workers' hands are the most common vehicle for the transmission of healthcare-associated pathogens from patient to patient and within the healthcare environment. Hand hygiene is the leading measure for preventing the spread of antimicrobial resistance and reducing healthcare-associated infections (HCAIs), but healthcare worker compliance with optimal practices remains low in most settings. This paper reviews factors influencing hand hygiene compliance, the impact of hand hygiene promotion on healthcare-associated pathogen cross-transmission and infection rates, and challenging issues related to the universal adoption of alcohol-based hand rub as a critical system change for successful promotion. Available evidence highlights the fact that multimodal intervention strategies lead to improved hand hygiene and a reduction in HCAI. However, further research is needed to evaluate the relative efficacy of each strategy component and to identify the most successful interventions, particularly in settings with limited resources. The main objective of the First Global Patient Safety Challenge, launched by the World Health Organization (WHO), is to achieve an improvement in hand hygiene practices worldwide with the ultimate goal of promoting a strong patient safety culture. We also report considerations and solutions resulting from the implementation of the multimodal strategy proposed in the WHO Guidelines on Hand Hygiene in Health Care.
authors.affiliation: First Global Patient Safety Challenge, World Alliance for Patient Safety, IER/PSP, Room L319, L Building, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. allegranzib@who.int
authors.forename: B
authors.initials: B
authors.lastname: Allegranzi
authors.forename: D
authors.initials: D
authors.lastname: Pittet
mesh_terms: D000438:Alcohols / Q000008:administration & dosage; D003428:Cross Infection / Q000517:prevention & control*; D019983:Guideline Adherence; D006235:Hand Disinfection / Q000379:methods / Q000592:standards; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D006920:Hygiene; D017053:Infection Control / Q000379:methods / Q000592:standards; D014944:World Health Organization
chemical_list: D000438:Alcohols