Geneva - On Hand Hygiene Day (May 5), the World Health Organization (WHO) is encouraging patients and their family members to join health workers in their efforts to practice good hand hygiene. Every year, hundreds of millions of patients around the world are affected by health care-associated infections. These lead to significant physical and psychological suffering and sometimes death of patients, and financial losses for health systems. More than half of these infections could be prevented by caregivers properly cleaning their hands at key moments in patient care.

Healthcare-associated infections usually occur when germs are transferred by healthcare providers’ hands touching the patient. The most common infections are urinary tract and surgical site infections, pneumonia and infections of the bloodstream. Of every 100 hospitalized patients, at least 7 in developed and 10 in developing countries will acquire a health care-associated infection. Among critically ill and vulnerable patients in intensive care units, that figure rises to around 30 per 100.

Practicing good hand hygiene during healthcare by using alcohol-based hand rubs or washing hands with soap and water if visibly dirty reduces the risk of these infections.

"Healthcare-associated infections are a major burden around the world and threaten the safety and care of patients,” says Sir Liam Donaldson, WHO Envoy for Patient Safety and former Chief Medical Officer for England. “I urge the health care and patient communities to take firm and decisive action to save lives from this preventable harm.”

"Save Lives: Clean Your Hands" global campaign

More than 15 700 health facilities with more than 9 million health workers in 168 countries have registered their commitment to good hand hygiene as part of the WHO global campaign: “SAVE LIVES: Clean Your Hands”. The campaign has been running since 2009 and 12 new countries joined in the last year.

According to the WHO Clean Care is Safer Care Programme, when working with patients, hand hygiene should be performed at 5 key moments, preferably by using an alcohol-based rub or by handwashing with soap and water if hands are visibly dirty. The five moments for hand hygiene are:

• before touching a patient

• before clean and aseptic procedures (e.g.inserting devices such as catheters)

• after contact with body fluids

• after touching a patient

• after touching patient surroundings.

Patient participation

Generating public awareness and patient participation are key to enhancing opportunities for patient safety. Many health facilities educate and encourage patients and their families to participate in hand hygiene. According to a new survey conducted by WHO and its Collaborating Centre on Patient Safety, the University of Geneva Hospitals, patient participation is considered a useful strategy for improving hand hygiene and creating a positive patient safety climate in the facilities implementing it.

“Patient participation can be a powerful tool to achieve improvements in health care,” says Dr. Benedetta Allegranzi, team lead in the WHO Patient Safety Clean Care is Safer Care programme. “Although the ability of patients to be involved will vary in different cultures and situations, family members of patients often help with caregiving and they are some of the best advocates for their loved ones. That makes them good allies in this process.”

Patients and their family members can participate by:

• asking for information about any existing initiatives that involve patients at the health facility

• asking health workers who are about to touch them to clean their hands, and thanking them when they do.

“To be successful, activities to empower patients should ensure the buy-in of health workers and respect the local culture,” recommends Professor Didier Pittet, lead advisor to WHO’s Clean Care is Safer Care programme and Director of Infection Control at the University of Geneva Hospitals.

On and around May 5 this year, WHO also invites health facilities to take action on monitoring hand hygiene practices and providing feedback to health workers. These are essential elements of successful strategies to reduce healthcare-associated infections.