# 5892
One hundred and sixty-three years ago, a Hungarian physician named Ignaz Semmelweis published a controversial medical book called Etiology, Concept and Prophylaxis of Childbed Fever.
At the time, childbed - or puerperal fever - was a common cause of mortality and morbidity among postpartum women. Semmelweis demonstrated that it could be greatly reduced by simply having doctors wash their hands before performing gynecological exams.
Sure, that makes sense today, but at the time his theories were considered radical (Pasteur wouldn’t come up with his `germ theory’ for another 17 years).
Besides, it was outrageous to suggest that doctors might actually be causing disease and death among their patients.
Semmelweis was ridiculed, ostracized and eventually forced to leave his hospital post. He died at the age of 47 in an asylum, a broken man.
More than 160 years later, infection control professionals continue to drum the message of proper hand hygiene into HCWs (Health Care Workers), yet lapses remain common.
A discouraging report from the Irish Independent.
Doctors 'worst' at basic hand hygiene
By Eilish O'Regan Health Correspondent
Wednesday October 12 2011
Nearly one in four doctors fails to clean their hands between patients -- increasing the risk of passing on potentially life-threatening infection, a damning report revealed yesterday.
The survey of hand hygiene in 36 acute hospitals revealed that doctors were the worst offenders (61pc) and that, overall, nearly three in 10 staff were not following the basic rule of infection control.
The actual audit report is available on the HPSC (Health Protection Surveillance Center) website.
June 2011: Hand Hygiene Audit Results (Period 1)
File Size: (278kB)
Publication Date: 11 October 2011Frequently Asked Questions on Hand Hygiene Audit Results
File Size: (167kB)
Publication Date: 11 October 2011
The `good news’ is that nurses – who likely have the greatest direct contact with patients – were the best at hand hygiene, with a compliance rate of just over 80%.
The `bad news’ is that this survey may not accurately reflect the level of compliance when auditors are not present. The report explains:
3. Limitations of Auditing Hand Hygiene with Direct Observation
The results may not be reflective of healthcare worker compliance at all times. Compliance with hand hygiene is measured by auditors observing healthcare workers undertaking patient care. It is well recognised that workers will change their behaviour, if aware that they are being observed (Hawthorne effect).
However, it is also known that this effect wears off over time and that healthcare workers under observation may not be aware (due to the many competing demands on their attention) of the presence of the auditor. In addition, the purpose of auditing is to improve practice, therefore any action that improves compliance increases patient safety. Auditors are requested to give immediate feedback to ward staff following an audit, thereby increasing awareness and knowledge of hand hygiene.
While overall compliance was just under 75%, the goal is to raise that to 90% by 2013.
Given the heavy burden of HAIs (Hospital Acquired Infections), on May 5th of this year the World Health Organization promoted a CLEAN YOUR HANDS DAY to encourage HCWs to improve and sustain hand hygiene practices around the world.
Clean Care is Safer Care
First Global Patient Safety Challenge
Clean Care is Safer Care
The goal of Clean Care is Safer Care is to ensure that infection control is acknowledged universally as a solid and essential basis towards patient safety and supports the reduction of health care-associated infections and their consequences.
As a global campaign to improve hand hygiene among health-care workers, SAVE LIVES: Clean Your Hands is a major component of Clean Care is Safer Care. It advocates the need to improve and sustain hand hygiene practices of health-care workers at the right times and in the right way to help reduce the spread of potentially life-threatening infections in health-care facilities.
Below you’ll find some resources from the WHO, including posters, PDF files, and articles.
Five Moments for Hand Hygiene
The newly developed Five Moments for Hand Hygiene has emerged from the WHO Guidelines on Hand Hygiene in Health Care (Advanced Draft) to add value to any hand hygiene improvement strategy. Quite simply, it defines the key moments for hand hygiene, overcoming misleading language and complicated descriptions. It presents a unified vision and promotes a strong sense of ownership.
Not only does the Five Moments align with the evidence base concerning the spread of HAI but it is interwoven with the natural workflow of care and is designed to be easy to learn, logical and applicable in a wide range of settings. Find out more about your Five Moments by clicking the links below.
Whether you work in a healthcare setting or not, today would be a good day to visit the CDC’s hand hygiene website, where you will find many resources, including a link to a new iPad/iPhone application called iScrub.
To round out this entry, some oldies but goodies from the AFD archives.
Doing The Hand Jive
Hand Hygiene Among Doctors Exposed
Gonna Wash Those Germs Right Off Of My Hands
And finally a collection of Hand Washing posters can be found at:
