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How Hand Hygiene Impacts Hospital Infection Rates

How Hand Hygiene Impacts Hospital Infection Rates

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Main Category: Public Health
Article Date: 04 May 2012 - 14:00 PDT

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The Cleanyourhands campaign was initiated in January 2005 across all acute NHS trusts in England and Wales after concerns were raised over high levels of infections and low levels of hand hygiene. Worldwide, the campaign is the first to be done nationally.

A study published in BMJ, which coincides with the World Health Organization SAVE LIVES: Clean Your Hands campaign on the 5 May 2012, reveals that the campaign played a significant role in reducing rates of some healthcare associated infections in hospitals across England and Wales.

The WHO's SAVE LIVES: Clean Your Hands campaign is part of a worldwide effort to improve hand hygiene amongst healthcare workers, in order to prevent infections that are often life threatening. For instance, by reducing the high levels of Staphylococcus aureus infection, like meticillin resistant (MRSA) and meticillin sensitive (MSSA) and Clostridium difficile infection, which are spread through contamination of healthcare workers hands.



The campaign involved various preventive actions, such as regular audits and feedback, having alcohol hand rub at each hospital bedside, distribution of posters and providing patients with materials to remind healthcare workers to clean their hands. In addition, trusts were advised to order their soap and alcohol hand rub from central NHS supply agencies to ensure all products had met efficacy, safety, and acceptability standards.



In the first study, researchers from the Royal Free Campus, the University College London Medical School and the Health Protection Agency evaluated what impact this campaign had in terms of hospital procurement rates of alcohol hand rub and soap in relation to infection rates, which were measured every three months between 2005 and 2009 in all 187 acute NHS hospital trusts.



The findings revealed that over the study period the combined procurement of soap and alcohol hand rub almost tripled from 21.8 to 59.8 mL per patient bed day, whilst MRSA infections dropped from 1.88 to 0.91 cases per 10,000 bed days and C difficile infections dropped from 16.75 to 9.49 cases. There was no drop in MSSA infection rates. 

Increased procurement of soap was independently linked to lower rates of C difficile infections over the study period, whilst a higher procurement of alcohol hand rub was independently linked to lower rates of MRSA infections, although the effect was only observed within the last year of the study. These robust and independent links did not change after accounting for variable interventions.



The researchers point out that higher procurements were not the only cause for these reductions. Other strong independent factors were the publication of the 2006 Health Act as well as visits by Department of Health improvement teams. They conclude h
owever, that the Cleanyourhands campaign is linked to higher procurement of soap and alcohol hand rub which in turn assisted in reducing rates of some healthcare associated infections, saying:

"The study suggests that national infection control interventions, including a hand hygiene campaign, undertaken in the context of a high profile political drive, can successfully reduce selected healthcare associated infections. The WHO offers a similar intervention to all countries signed up to the SAVE LIVES: Clean Your Hands initiative, giving the study findings international significance."

Written By Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

"Evaluation of the national Cleanyourhands campaign to reduce Staphylococcus aureus bacteraemia and Clostridium difficile infection in hospitals in England and Wales by improved hand hygiene: four year, prospective, ecological, interrupted time series study"
Sheldon Paul Stone, Christopher Fuller, Joan Savage, Barry Cookson, Andrew Hayward, Ben Cooper, Georgia Duckworth, Susan Michie, Miranda Murray, Annette Jeanes, J Roberts Louise Teare and Andre Charlett
BMJ, May 2012, doi: 10.1136/bmj.e3005 Please use one of the following formats to cite this article in your essay, paper or report:

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