Since 2009 each year healthcare workers (HCWs) around the world celebrate International Hand Hygiene Day (IHHD) on the 5th of May. The purpose of IHHD is to draw HCW and public attention to the importance of cleaning one’s hands to reduce the spread of infection and disease in public and healthcare settings.
For several hundred years we have known that if our hands are clean anything or anyone we touch is not placed at risk from germs that we may otherwise carry on our hands. Children are typically taught from an early age that cleaning their hands is important after using the toilet, before preparing or eating food, after touching animals and after contact with other soiled objects. However, in most domestic and social settings there are no specific penalties for not cleaning your hands and few people ever probably think that the infectious diseases they acquire may be related to their or someone else’s failure to clean their hands.
For HCWs the action of cleaning their hands in a healthcare settings is referred to as hand hygiene. For more than 140 years the association between unclean HCW hands and spread of infection to patients in their care has been proven. In 2009 the World Health Organisation spearheaded a massive global campaign to increase HCW hand hygiene compliance. The campaign included ways to measure, record and understand HCW hand hygiene behaviour.
A non-HCW and especially someone who has ever been cared for in a clinical setting would reasonably expect that all HCWs follow hand hygiene recommendations all of the time. Consistently since 2009 international and national data have confirmed that on average HCWs perform hand hygiene only about three-quarters of the times they should. Despite substantial investment by governments, expert clinicians, hand hygiene product manufacturers and by infection prevention personnel working at the coalface of healthcare, few hospitals have been able to reach 100% hand hygiene compliance. However even in those hospitals who have observed 100% compliance among staff the hospital’s rate usually drops to around 75% within a few months.
Exciting developments in technology, behavioural understanding and clinical design are currently under development in various parts of the world. Most are moving towards systems that either automatically ensure the cleanliness of HCW hands or systems that register and immediately report failure to perform hand hygiene. Many hospitals are also exploring ways in which patients and their families and friends can become self-advocates for HCW hand hygiene. Governments, including our own Australian national government and several state and territory governments, publically report hand hygiene compliance rates from individual public hospitals.
Who would have ever imagined getting HCWs to always perform such a simple yet critical task would be so difficult? More alarmingly, who would have ever thought that after the investment of millions of Australian tax-payer dollars our national average for HCW hand hygiene compliance is under 80%?
If you care about the state of the hands of anyone who is preparing or serving you food, anyone who handles something that you may soon touch or anyone who is trusted to care for you in any healthcare setting before they interact with you please ask them “have you cleaned your hands?”. Those five words referring to the cleanliness of the five fingers of each hand are what the 5th of the 5th is all about.
Infection Control Plus wishes you a happy and healthy 2013 International Hand Hygiene Day. If you would like more information about hand hygiene in domestic, social, institutional or clinical settings please contact us.