Next Monday, 5th May, is World Hand Hygiene Day. Each year since its launch by the World Health Organisation in 2009, the ‘Save Lives: Clean Your Hands’ campaign has aimed to maintain a global profile on the importance of hand hygiene in healthcare in particular, and to support hand hygiene improvement globally. As someone who was taught how to wash my hands properly (and particularly so pre-mealtimes!) at toddler stage, I’ve found it hard to get my head around others who are lucky enough to enjoy decent handwashing facilities, not having the savvy to wash their hands properly as required. But it’s never as ‘cut and dried’ as that, is it? 

  

A new study, ‘Uncovering the obstacles: a comprehensive analysis of barriers to hand hygiene adherence among healthcare providers: a systematic review’, published in BMC Infectious Diseases, makes interesting reading. It highlights some of the challenges we face globally which leave health professionals and patients vulnerable to healthcare-acquired infections, and may well provide that basis for improvement in hand hygiene practices for which we’ve searched for so long, since it’s so comprehensive. The research covered 28 studies already conducted in different regions of the world, (representing six continents) and published between 2010 and 2024. While behavioural and organisational barriers were the most highlighted themes, physical barriers such as the unavailability and inconvenience of hand hygiene resources gained the most attention by participants across all the studies. Societal/interpersonal barriers characterised by negative social influence and unsupportive colleagues were also an issue. The study delves deeply into the reasons why. 

  

“Hand hygiene is the most effective and feasible infection prevention and control measure within the healthcare facilities,” it says. “Despite the ease and simplicity of the technique, the adherence rate among health professionals remains suboptimal. Hence, developing targeted interventions to improve adherence requires a clear understanding of these obstacles. Our findings underscore that the intertwined nature of these barriers requires a multifaceted approach to improve hand hygiene adherence. Studies suggested that improving adherence alone can reduce up to 50% of the transmission of pathogens within the healthcare settings. A significant reduction of healthcare-acquired infections can be achieved with an approximately 60% adherence rate among healthcare workers within the facility. However, almost 61% of health professionals don't comply with the guidelines.” 

  

Having read the study, it’s become clear to me that the ‘one size fits all’ approach to hand hygiene adherence that we so often see, is not the answer to achieving anything like reasonable compliance globally. Different regions and types of facilities clearly need to be targeted in ways that overcome the particular and often complex barriers cited by those working in them. Those in our industry may well be able to do that… 

  

Read the study here