from Fitzgerald et al. 2013
published in J Hosp Infect 84(1):27-31
DOI 10.1016/j.jhin.2013.01.008

Hand hygiene after touching a patient's surroundings: the opportunities most commonly missed

Trainings are essential parts of multimodal interventions to improve cleaning, hand and surface hygiene, saving costs and reduction of HAIs

The study conducted in different wards of the University College London Hospitals involved fifty-eight 90-minute sessions of observation in both open bays and isolation rooms. A special analysis method was used to record the employees’ movements from one location to another as well as the frequency of movement. Hand-hygiene audits were carried out using the “Five Moments for Hand Hygiene” model developed by WHO. In the intensive care unit, most movements occurred right next to the bed. Bedside computers and equipment trolleys were most commonly touched, often even directly after patient contact. Compliance with hand hygiene was 60 % (shared rooms) and 62 % (single rooms). In the gastroenterology department, most movements were between beds. Observed hand hygiene compliance was 34 % here. Compliance between patient contact and touching computer surfaces was low (14 % - 22 %), illustrating the risk of pathogen transmission from patients to surfaces. Healthcare providers must be made aware that measures perceived as low risk in daily routine may also involve the transmission of infection. Hence, training and intervention programmes should include possible contamination of ward computers, case notes and door handles.