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Promotion of Hand Hygiene: Magic, Hype, or Scientific Challenge?

Pittet Didier , MD, MS
Infection Control and Hospital Epidemiology
Vol. 23, No. 3 (March 2002), pp. 118-119
DOI: 10.1086/502019
Stable URL:
Page Count: 2
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EXCERPT The compliance of healthcare workers (HCWs) with hand hygiene practices is universally low.1 The challenge of promotion of hand hygiene could be summarized in two simple questions: (1) How can we change the behavior of HCWs? and (2) How can we maintain such change? Predisposing, enabling, and reinforcing factors should be taken into account for the successful promotion of hand hygiene and prevention of nosocomial infections.1‐3 Among predisposing factors for noncompliance with hand hygiene are physician and nursing assistant status (rather than a nurse), glove wear, skin irritation by hand hygiene agents, and the critical care setting, particularly when heavy workloads exist with an increased number of opportunities for hand hygiene per hour of patient care.1,3,4 Time constraint was the most influential parameter in the largest epidemiologic survey conducted.4 Self‐reported factors for poor adherence with hand hygiene include poor accessibility of sinks or a lack of convenient tools for hand hygiene, lack of knowledge, disagreement with or even skepticism about recommendations, the feeling that hand hygiene might interfere with HCW–patient relations, lack of scientific information reporting a definitive impact of improved hand hygiene on nosocomial rates, the impression that the risk for cross‐transmission is low for the patients, the belief that glove use dispenses from hand hygiene, and the idea that patient needs take priority over hand hygiene.1‐5 Additional key factors for noncompliance are forgetfulness, the lack of a role model in colleagues or superiors, and the absence of an institutional priority for hand hygiene.

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