WHO says hand hygiene strategy feasible, sustainable

HandwashingThe World Health Organization’s (WHO) strategy for improving hand hygiene is easy for health-care workers to practise, according to a new study published on Friday in Lancet Infectious Diseases.

It observed that health care-associated infections were a major threat to patient safety worldwide and transmission in these settings was mainly from the hands of health-care workers.

The report dubbed: “Global implementation of WHO’s multimodal strategy for improvement of hand hygiene: a quasi-experimental study,” was made available to the Ghana News Agency by Tarik Jasarevic of the WHO Communication Unit in Geneva.

It noted that in six sites in Costa Rica, Italy, Mali, Pakistan and the Kingdom of Saudi Arabia, the research team implemented WHO’s strategy in 55 departments in 43 hospitals.

It said during the two-year period between December 2006 and December 2008, compliance with best practices increased from 51 per cent before the study to 67 per cent and infrastructure and staff knowledge were also significantly improved in all sites.

The study also demonstrated that the change in practices and safety culture was sustained up until at least two years since the conclusion of the testing phase.

“Health care-associated infections usually occur when germs are transferred by health-care providers’ hands touching the patient.

“The most common infections are urinary tract and surgical site infections, pneumonia and infections of the bloodstream and are often caused by multi-drug resistant germs such as methicillin-resistant S. aureus (MRSA).

“Of every 100 hospitalized patients, at least seven in developed and 10 in developing countries will acquire a health care-associated infection.

“Among critically ill and vulnerable patients in intensive care units, that figure rises to around 30 per 100,” the study stated.

It said practising good hand hygiene during health care reduced the risk of these infections and the spread of antimicrobial resistance.

“Infection prevention and control is one of the key policy pillars identified by WHO to combat the growing problem of antimicrobial resistance.

“The other pillars include: appropriate national policies and plans, improving surveillance of these resistant pathogens; uninterrupted access to good quality essential medicines; proper use of medicine, and more research and development of new treatments,” the study said.

According to the WHO Clean Care is Safer Care Programme, when working with patients, hand hygiene should be performed at five key moments, preferably by using an alcohol-based rub or by hand-washing with soap and water if hands were visibly dirty.

It noted that the five moments for hand hygiene are: before touching a patient; before clean and aseptic procedures (e.g., inserting devices such as catheters); after contact with body fluids; after touching a patient; after touching patient surroundings.

The report said the strategy had been implemented so far in more than 15,700 health-care settings in 168 countries worldwide and more than 50 governments had based their national hand hygiene campaigns on it.

The current study validates its use as a universal gold standard of patient care.

WHO’s hand-hygiene compliance strategy consists of five main components: ensuring health-care workers have access to alcohol-based handrub at the point of patient care; training and education of health-care workers on the most important times in patient care for hand hygiene; monitoring and feedback on compliance; visual reminders at the point of care in the workplace; creation of a culture of attention to patient and health-care worker safety within the institution.

Source: GNA

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