World Hand Hygiene Day is celebrated on May 5 every year. This day aims to
raise awareness about the importance of hand hygiene in healthcare settings. The goal is to encourage healthcare workers to practice good hand hygiene, which is a crucial step in preventing the spread of infections and saving lives. The theme of Hand Hygiene Day for 2024 targets to promote knowledge and capacity building of healthcare workers through innovative and impactful training and education on infection prevention and control 1.
On this “Hand Hygiene Day”, the pioneering work of Ignac Semmelweis is gratefully acknowledged, who was the first to recognize and emphasize the crucial role of hand hygiene in preventing the spread of infection and ensuring patient safety. He has established a strong, specific, temporal causal association between unclean hands and puerperal fever. Although not accepted during his lifetime, this causal hypothesis contributed significantly to the understanding of etiopathophysiology of not only puerperal fever but also many other communicable diseases. Semmelweis' concepts of hand hygiene remain a cornerstone of infection control measures, playing a vital role in the management of the COVID-19 pandemic.
Healthcare-associated infections (HAIs) can be significantly prevented and reduced through the implementation of effective hand hygiene practices, coupled with robust infection prevention and control measures, in healthcare settings. Out of every 100 patients in acute-care hospitals, seven patients in high-income countries (HICs) and 15 patients in low- and middle-income countries (LMICs) will acquire at least one health care-associated infection during their hospital stay. Up to 30% of patients in intensive care can be affected by HAIs, with an incidence that is two to 20 times higher in LMICs than in HICs, in particular among neonates 2. HAI due to multidrug-resistant organisms (MDROs) is an added challenge as number of antibiotics available to treat such infections is extremely limited 3. The common MDROs include Methicillin resistant Staphyloccous aureus, Carbapenems resistant Enterobacteriaceae, Vancomycin resistant Enterococci spp, Multi-resistant Acinetobacter baumannii, drug resistant Candida auris, extensively drug-resistant Salmonella Typhi, extended-spectrum beta-lactamase gram-negative organisms. Mortality among patients infected with resistant microorganisms is at least two to three times higher than among those infected with sensitive microorganisms 2. The spread of MDROs in healthcare settings results from poor compliance with IPC practices by healthcare workers. The contaminated hands and contaminated items/surfaces in the hospital environment often lead to outbreaks and serious infections, especially in immunocompromised patients. Therefore, implementation of standard precautions including hand hygiene for all patients all the time is key to preventing the spread of all microbes and MDROs. The report has highlighted that by implementing hand hygiene measures there can be a reduction in HAIs to 70% 2.
In LMICs, hospital patients are exposed to higher rates of HAIs. This is due to challenges to the implementation of effective hand hygiene strategies. The WHO has launched its Multimodal Hand Hygiene Improvement Strategy which provides an evidence-based framework for developing a locally adapted implementation plan for hand hygiene promotion. The strategy involves five components including system change, hand hygiene education and training, evaluation and feedback, reminders in the workplace, and institutional safety climate. Implementation of MHHIS has been associated with a significant increase in hand hygiene compliance and a reduction in the number of microorganism.
There is a huge economic impact of hand hygiene intervention. Organization for Economic Cooperation and Development (OECD) highlighted that by improving hand hygiene between 2015 and 2050, more than 30,000 deaths each year across all the G7 countries and around 19,000 across EU/EEA members will be prevented 4. WHO reported that by improving hand hygiene in healthcare settings could save about US$ 16.50 in reduced healthcare expenditure for every dollar invested 2.
Clean hands save lives and prevent the spread of infections. Let's pledge together to ensure that hand hygiene is practiced by everyone, everywhere, at all times. Let's continue to promote knowledge, capacity building, and innovative training to improve infection prevention and control.
Written by ISID Emerging Leader, Afreenish Amir