Hand hygiene initiative reduces hospital infections in Australia

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The National Hand Hygiene Initiative reduced infections in 132 hospitals in the country

Since its implementation in 2009, the National Australian Hand Hygiene Initiative (NHHI) has seen significant, sustained improvements in hand hygiene compliance among Australian healthcare workers.

It reduced risks of potentially fatal healthcare-associated Staphylococcus aureus infection, according to new research being presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Amsterdam, Netherlands (13-16 April), and published in The Lancet Infectious Diseases.

For every 10% increase in hand hygiene compliance, there was an associated 15% decline in the incidence of S. aureus bloodstream infection in Australia’s 132 largest public hospitals. These hospitals provide over three-quarters of all public inpatient care (over 15 million patients-days nationally in 2016-17).

For every 10% increase in hand hygiene compliance, there was an associated 15% decline in the incidence of S. aureus bloodstream infection in Australia’s 132 largest public hospitals

The results were achieved by promoting WHO’s ‘5 Moments for Hand Hygiene’ to reduce the risk of healthcare associated infection–before touching a patient; before a clean procedure; after exposure to body fluids/wounds; after touching a patient; and after touching a patent’s surroundings.

The national culture-change programme could be a template for similar initiatives in other countries, researchers say.

“Hospital-acquired infections are a major concern for hospitals around the world and S. aureus is among the most dangerous,” says Professor Lindsay Grayson from Hand Hygiene Australia who led the research. “The risks to patients are enormous, as are the associated hospital costs. Despite robust evidence supporting improved practices for hand hygiene, securing compliance is notoriously difficult, and few national programmes have been sustained in the long-term.”

S. aureus is the leading Gram-positive bacterium responsible for hospital-acquired infections including endocarditis, acute pneumonia, and sepsis. S. aureusinfections are linked to poor hand hygiene compliance.

The analysis found a significant improvement in hand hygiene compliance in hospitals nationally–from 64% (36,213 of 56,978) of potential hand hygiene opportunities (Moments) in 2009 to 84% (494,673 of 586,559) in 2017. 

While compliance steadily improved for each healthcare worker type (eg, doctor, nurse, and allied health), adherence was consistently 10-15% lower among medical staff compared to nursing staff over the 8-year study.