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Author: Pittet, D. et al. Source: Lancet, 2000, 356: 1307-1312


Pittet, D. et al.

Effectiveness of a hospital-wide programme to improve compliance with hand hygiene

Background: Hand hygiene – in particular hand disinfection with preparations based on alcohol – is considered the most important measure to prevent hospital-acquired infections (HAI). However, compliance with hand hygiene protocols is commonly poor. Pittet et al. conducted a study in the University Hospitals Geneva, Switzerland, to improve the compliance rate and assess its effect on the HAI rate.

The 5-year study, which started in 1995, included the implementation of a multimodal campaign for improving hand hygiene compliance. The campaign’s emphasis was on strategically displayed posters developed by healthcare workers to remind employees of hand hygiene measures. In addition, the campaign focussed on promoting the use of alcohol-based disinfectants, which were easily accessible in dispensers next to all patient beds and in pocket bottles. Compliance with hand hygiene protocols were monitored before (December 1994) and throughout the campaign (twice yearly, in June and December, from 1995 to 1997) by direct observation. More than 20,000 opportunities for hand hygiene were observed and evaluated. Additionally, the prevalence of HAI was recorded.

Results: Throughout the course of the study, the compliance rate increased from 48 % in 1994 to 66 % in 1997. This improvement was clearly associated with the increase in compliance with hand disinfection, which rose from 13.6 % to 37 %; compliance achieved through standard handwashing with soap and water remained stable at around 30 %. At the same time, the HAI rate significantly decreased from 16.9 % to 9.9 %.

Conclusions: The study could demonstrate that a hospital-wide programme can improve hand hygiene compliance effectively and also decrease the rate of nosocomial infection significantly. The increase in compliance greatly depended on the easier accessibility of alcohol-based hand disinfectants.

Lancet, 2000, 356: 1307–-1312

Please click here to view the original study.

Additional information on hand hygiene programmes is available under CENTER.