Research for infection protection

Basis for good hand hygiene compliance: skincare substances, attitudes and role models

Hand disinfection is the most important measure to prevent the transmission of nosocomial infection. However, although medical and nursing staff are aware of the vital importance of hand disinfection, compliance is often inadequate: studies show that only every other necessary hand disinfection is actually performed in clinical routine [1]. Thus, the promotion of the compliance is one of the main hygienic challenges healthcare facilities have to overcome.

Increase user acceptance

A hand disinfectant’s skin tolerability is an important prerequisite for healthcare workers to actually carry out hand disinfection. Hence, it has a share in good compliance. The reason: rubs that are gentle on the skin are better accepted and therefore used more reliably. A new study conducted on the occasion of Sterillium®’s 50th anniversary demonstrates that well-formulated hand disinfectants not only are skin friendly but also have skin-nurturing properties. Already after one week of repeated application, Sterillium® classic pure increases the skin hydration by an average of approx. 30 % [2] and thus contributes to improved skin health.

Changing implicit attitudes

A good feeling on the skin after hand disinfection can also contribute to enhanced compliance. The central factor here are the nursing staff’s and physicians’ implicit attitudes towards hand hygiene. These attitudes that are not accessible consciously determine the action with spontaneous, unplanned behaviours. They are based on the principle that favourable or unfavourable connotations in the brain are retrieved automatically. When users associate hand disinfection with something pleasant, it will have a positive connotation in their mind. These positive connotations may result from, for example, an appealing scent or a good feeling on the skin after hand disinfection. The more favourable the implicit attitude of nursing staff and physicians towards hand hygiene is, the more frequent they disinfect their hands [3].

Be a role model

In addition to the user acceptance, it is the behaviour of co-workers that has a significant influence on hand hygiene compliance. Especially physicians and experienced nursing staff are perceived as role models in hand disinfection. Studies show: when physicians set a good example and carry out hand disinfection as indicated, this has a positive influence on the compliance of other employees [3].

Also when stepping into the immediate patient surroundings there is a strong imitative instinct with regard to hand hygiene: if the first employee disinfects her/his hands when entering the patient room, following persons will do so as well [3].

Study abstracts on role models you will find here and in the Study supplement on infection control and hand hygiene.

Wanted: role models – nominate your ”Modern Day Hero in Hygiene” at

1. Pittet et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet, 2000, 356: 1307-1312
2. Evaluating the effect of a hand sanitizer using an exaggerated handwash method. 2014. RCTS‘ Study No. 3295.
3. Keller, J. (10.07.2015). The gap between knowledge and action – the attitude matters. Presentation held at the lunchtime symposium “Healthy skin – better infection protection. New findings on compliance.” of PAUL HARTMANN AG/BODE Chemie on 10 July 2015 in Berlin.
4. Haessler et al. (2012) Getting doctors to clean their hands: lead the followers. BMJ Qual Saf. 2012, 21: 499-502.