title: Back to the future: rising to the Semmelweis challenge in hand hygiene.
abstract: Hand hygiene is the single most important intervention for reducing healthcare associated infections and preventing the spread of antimicrobial resistance. This sentence begins most publications regarding hand hygiene in the medical literature. But why - as we mark 150 years since the publication of Ignaz Semmelweis' landmark monograph on the subject - do we continue to repeat it? One might be tempted to regard it as a truism. However, while tremendous progress has certainly been made in this field, a significant amount of work is yet to be done in both strengthening the evidence regarding the impact of hand hygiene and maximizing its implementation. Hand hygiene cannot yet be taken for granted. This article summarizes historical perspectives, dynamics of microbial colonization and efficacy of hand cleansing methods and agents, elements and impacts of successful hand hygiene promotion, as well as scale-up and sustainability. We also explore hand hygiene myths and current challenges such as monitoring, behavior change, patient participation and research priorities.
authors.affiliation: Infection Control Program & World Health Organization Collaborating Centre on Patient Safety (Infection Control & Practice Improvement), University of Geneva Hospitals, Switzerland.
authors.forename: Andrew
authors.initials: A
authors.lastname: Stewardson
authors.forename: Benedetta
authors.initials: B
authors.lastname: Allegranzi
authors.forename: Hugo
authors.initials: H
authors.lastname: Sax
authors.forename: Claire
authors.initials: C
authors.lastname: Kilpatrick
authors.forename: Didier
authors.initials: D
authors.lastname: Pittet
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D019983:Guideline Adherence; D006235:Hand Disinfection / Q000379:methods*; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D017053:Infection Control / Q000266:history* / Q000379:methods