WHO hand washing strategy feasible for healthcare workers

The World Health Organization's strategy for improving hand hygiene is easy for healthcare workers to practice, according to a study published on Friday in Lancet Infectious Diseases.

Researchers in Pakistan, Mali, Italy, Costa Rica and the Kingdom of Saudi Arabia implemented the WHO's strategy in 55 departments in 43 hospitals over the course of two years. Compliance with best practices rose between December 2006 and December 2008 from 51 percent to 67 percent. The change in practices and safety culture was sustained up until at least two years since the testing phase concluded.

"The WHO strategy was based on a multimodal approach previously proven to have a dramatic effect in reducing the number of health-care related infections at the WHO Collaborating Centre on Patient Safety at the University of Geneva Hospitals, but now for the first time we have evidence of its feasibility and successful effect to improve hand hygiene in a variety of different geographical and income settings, with even greater impact in low-income and middle-income countries than in high-income countries," Benedetta Allegranzi, the lead author of the paper, said.

Healthcare-associated infections typically occur when germs are transferred by the hands of healthcare providers to the patient. Common infections include surgical site infections, urinary tract infections, bloodstream infections and pneumonia. The infections are frequently caused by multi-drug resistant germs like methicillin-resistant S. aureus.

Out of each 100 hospitalized patients, at least seven in developed and 10 in developing countries will acquire a healthcare-associated infection, a number that rises to approximately 30 out of 100 among critically ill and vulnerable patients in intensive care units. The practice of good hand hygiene in healthcare settings can reduce the risk of infections and the spread of antimicrobial resistance.

"As resistance to antibiotics and other key medicines becomes more common, it is more essential than ever to reduce the number of avoidable infections in hospital," Edward Kelley, the coordinator of the Patient Safety Programme at WHO, said. "The best way of reducing the number of people contracting antimicrobial resistant infections is to protect them from cross-transmission of germs through health-care workers' hands in the first place."

WHO's hand washing strategy has been used in more than 15,700 healthcare settings in 168 countries around the world. More than 50 governments based their national hand hygiene campaigns on the WHO's strategy.