Preventing Infection

It’s in your hands: The urgent importance of hand hygiene

Few people have recognised the medical necessity of hand hygiene the way Professor Didier Pittet has for more than a quarter-century. Pittet serves as the director of the Infection Control Programme at the University of Geneva Hospitals and Faculty of Medicine and World Health Organization (WHO Collaborating Centre on Patient Safety); in addition, he is the lead adviser of the WHO’s First Global Patient Safety Challenge: Clean Care is Safer Care. As a global authority in role of healthcare-associated infections (HAI), he gives us an overview of how hand hygiene makes a life-saving difference.

Why does hand hygiene deserve global focus?

Professor Pittet: Clean hands among medical professionals can prevent infections. At the moment, healthcare-associated infections kill more than 16 million people around the world each year. This is a higher rate of death than AIDS, tuberculosis and malaria combined.

What has changed since you began researching and developing programs on hand hygiene?

Pittet: When we began our research in 1994, medical professionals followed a standard method: hand washing with soap and water. At this time we were already able to demonstrate that it was impossible to fully clean your hands. Over the past 25 years, we’ve been able to verify via research that alcohol-based hand rubs, when applied at the appropriate times, can make a stronger difference. We’ve come to the conclusion that a multi-modal approach to change hand hygiene behaviour includes systematic change – making alcohol hand rubs available and accessible; providing ongoing training, education and feedback as to the vital importance of this issue; and creating individualised, institutionalised environments that consistently support the vital importance of hand hygiene.

What’s at stake in medical professionals maintaining better hand hygiene?

Pittet: In addition to an annual 16 million likely preventable deaths, we are talking about infections that are typically treated by antibiotics. As antibiotic resistance has grown exponentially, we must consider how we can prevent infections from occurring in the first place. Good hygiene is the most important tool to preventing antimicrobial resistance spread.

Is ‘perfect’ hand hygiene possible?

Pittet: Likely not – but this should not be a discouraging point. We know that hand hygiene promotion strategies need to be multi-modal, as I said, and this takes practice. But the good news is that medical facilities do not have to demonstrate perfect compliance with hygiene to see infection rates decrease. We have shown in our research that compliance can be, in fact, very low: perhaps around 10-20 percent compliant. But if a facility moves to even 40-50 percent compliant, our research shows that some infections can be reduced by up to 50 percent, and others up to 90 percent or more.

Why have you dedicated your knowledge and efforts to this issue?

Pittet:First, because of the evidence. Then, because of the colleagues who have joined this cause, first within Europe and now globally. In 2006 we designed another research project, and we have answers. More than 250 million people are following our campaign (via the web and social media). And alcohol-based hand rubs have joined WHO’s Essential Medicines list.

Today, we are developing concepts and models in Africa, for example, to produce alcohol rubs locally and make certain it is cost-efficient. We are creating jobs and saving lives. And this is because we gave our formulation of how to produce an effective, economical alcohol-based rub to WHO, and now it is produced locally in more than 60 countries at lower costs. Companies can still sell their alcohol-based hand rubs in the developed world, but now everyone has a chance – hand hygiene supports the rights of people all over the world. Indeed, health rights are a human right.

Prof. Didier Pittet
Pittet serves as the director of the Infection Control Programme at the University of Geneva Hospitals and Faculty of Medicine. The expert of infectious diseases was also the lead adviser of World Health Organization’s First Global Patient Safety Challenge: Clean Care is Safer Care.

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