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Hand hygiene is a great way to prevent infections. However, studies show that on average, healthcare providers clean their hands less than half of the time they should. This contributes to the spread of healthcare-associated infections that affect 1 in 25 hospital patients on any given day.

“Clean Care is Safer Care” was launched in October 2005 as the first Global Patient Safety Challenge (1st GPSC), aimed at reducing healthcare-associated infection (HCAI) worldwide. These infections occur both in developed and in transitional and developing countries and are amongst the major causes of death and increased morbidity for hospitalised patients.

According to the World Health Organization (WHO) the impact of (Healthcare associated infections (HCAI)

implies prolonged hospital stay, long-term disability, increased resistance of microorganisms to antimicrobials, massive additional financial burdens, an excess of deaths, high costs for the health systems and emotional stress for patients and their families. Risk of acquiring HCAI depends on factors related to the infectious agent (e.g. virulence, capacity to survive in the environment, antimicrobial resistance), the host (e.g. advanced age, low birth weight, underlying diseases, state of debilitation, immunosuppression, malnutrition) and the environment (e.g. ICU admission, prolonged hospitalisation, invasive devices and procedures, antimicrobial therapy). Although the risk of acquiring HCAI is universal and pervades every healthcare facility and system around the world, the global burden is unknown, because the difficulty of gathering reliable diagnostic data. This is mainly due to the complexity and lack of uniformity of criteria used in diagnosing HCAI and to the fact that surveillance systems for HCAI are virtually non-existent in most countries


Many studies have documented that Healthcare Workers (HCWs) can contaminate their hands or gloves with pathogens such as gram-negative bacilli, S. aureus, enterococci or C. difficile by performing “clean procedures” or touching intact areas of skin of hospitalised patients. Following contact with patients and/or a contaminated environment, microorganisms can survive on hands for differing lengths of time (2–60 minutes). HCWs’ hands become progressively colonised with commensal flora as well as with potential pathogens during patient care. In the absence of hand hygiene action, the longer the duration of care, the higher the degree of hand contamination.

  1. In hand hygiene promotion, programmes for HCWs focus specifically on factors currently found to have a significant influence on behaviour and not solely on the type of hand hygiene products. The strategy   should be multifaceted and multimodal and include education and senior executive support for       implementation.
  2. Educate HCWs about the type of patient-care activities that can result in hand contamination and about the advantages and disadvantages of various methods used to clean their hands.
  3. Monitor HCWs adherence to recommended hand hygiene practices and provide them with performance feedback
  4. Encourage partnerships between patients, their families and HCWs to promote hand hygiene in health-care settings (http://www.who.int/gpsc/5may/tools/en/index.html).

According to the Centre for Disease Control (CDC), the hospital-acquired infection rate is increasing. The CDC estimates these infections contribute to at least 80 000 patient deaths each year, and approximately 5 to 10 % of patients annually contract infections while in the hospital. Nosocomial infections kill more Americans every year than traffic accidents. According to a recent article in AJIC, handwashing is the single most important procedure in the prevention of nosocomial infections.

To encourage increased compliance, more innovative feedback and educational endeavors are needed as well as ways to make the handwashing process easier and faster (Drummond, 2019)