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Hand Hygiene Alone Isn’t Enough

Patrick Boshell
January 02, 2013
Hand Hygiene

Healthcare–associated infections continue to be a challenge in our health care institutions and the burden of illness associated with them is substantial. PIDAC’s Best Practices for Environmental Cleaning for Prevention and Control of Infections  states that, “In the health care setting, the role of environmental cleaning is important because it reduces the number and amount of infectious agents that may be present and may also eliminate routes of transfer of microorganisms from one person/object to another, thereby reducing the risk of infection.” 


We also recognize that the presence of microorganisms on objects and items in the health care environment doesn’t necessarily mean that they cause infection. There is, however, a growing body of evidence that indicates a cleaner environment will result in fewer health care-associated infections. A study by Dancer in 2010 highlights that cleaning, coupled with other key infection prevention and control interventions, is needed to help prevent the spread of infection in health care. This study states:


“Even exceptional hand hygiene is rendered invalid if the first object handled transfers pathogens to the patient via fingertips ... Infection control requires a multimodal focus encompassing a wide range of strategies. Each of these interventions plays an integral role in an overall hygiene program, which implies that all deserve consideration and resourcing.”

A study by Weber in 2010 notes that an estimated 20 to 40 percent of nosocomial infections have been attributed to cross-infection via the hands of healthcare workers. This hand contamination could result from direct patient contact or indirectly from touching contaminated surfaces or items. In some cases, the extent of patient-to-patient transmission has been found to be directly proportional to the level of environmental contamination.

Stiefel in 2011 showed that contact with items in the environment was just as likely to contaminate the hands of health care workers with MRSA as was direct contact with the patient’s skin. In 2008, Hayden described that VRE was transferred from contaminated sites to clean sites via health care worker’s hands or gloves. PIDAC describes several other studies which show that there is a direct means for microorganisms from contaminated surfaces to be transferred to hands.

So let’s just clean our hands –and our environments!


Article shared by SWOICN - South Western Ontario Infection Control Network.

Adapted from Infection Control Today, Environmental Hygiene: What We Know from Scientific Studies by Kelly M. Pyrek, August 30, 2012


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