Prevent the transmission of germs

It’s important for hospital staff always to disinfect their hands before and after touching a patient because the hands of people working in hospitals are the main transmission route for germs. Hospital staff temporarily pick up bacteria (usually without noticing) while they are treating and nursing patients, and bacteria can also be picked up from contaminated material or the hospital environment. A research team working with infection expert Didier Pittet from Geneva University Hospitals has shown that transmission can be cut by half if bacteria are killed systematically by using hand disinfectants containing alcohol.

Pittet’s team has identified five moments that are critical for hand hygiene, for example before and after every invasive procedure or contact with bodily fluids (such as blood or saliva). In order to see how thoroughly the guidelines for the five moments for hand hygiene are being followed, the hospital hygiene team at Cantonal Hospital St. Gallen has developed a measurement tool called “CleanHands” that Swissnoso, the national infection prevention centre, is making available to all hospitals in Switzerland. More than 100 healthcare institutions are currently using the “CleanHands” app. This enables the hospitals’ hygiene specialists to observe staff who come into contact with patients, and documents when they disinfect their hands.

Direct feedback
The tool automatically evaluates the information entered and provides the individual with immediate feedback. This is decisive in achieving a learning effect. If feedback is not received until several months later, staff do not see the connection to their everyday actions, writes Swissnoso in a review of the first national hand hygiene campaign carried out in 2005 and 2006. During that period, compliance with the guidelines increased from 54 to 68 per cent. The data recorded through “CleanHands” shows that this development has continued. The five moments for hand hygiene are observed best in geriatric medicine (87%). In the acute care hospitals the guidelines were followed in 76% of the cases recorded, and by nursing staff better than by doctors.
The hospitals’ major commitment to preventing infections is demonstrated not least by the training documents that many of them have developed to help their staff disinfect their hands correctly. Zurich University Hospital, for example, has produced a five-minute film in which a stay in hospital is compared in a humorous way with a long-haul flight and a member of the cabin crew explains the necessary hand hygiene measures to hospital staff.

Outstanding programme
Cantonal Hospital Neuchâtel has a programme called “HygièNE des mains” (hand hygiene) that received the European Hand Hygiene Innovation Award 2017. In addition to regular training and a personal hand hygiene kit for staff, it includes regular inspections during which a member of the hospital hygiene department accompanies staff on their rounds and analyses the hand hygiene measures that are employed. The hospital’s original aim when it started the programme in 2012 was for all staff who come into contact with patients to disinfect their hands in at least 80% of the observed cases.

“We have achieved and even exceeded this target. With a compliance rate of 86.2% we are 8% higher than the 90 other hospitals taking part in the Swissnoso ‘CleanHands’ module,” the hospital states proudly on its website. And then continues with its forthcoming shift in focus from quantitative to qualitative aspects. The “zéro bijou” (zero jewellery) project is already off the ground, promoting an environment favourable to good hand disinfection: hands wearing no rings.

More information:

- The five moments for hand hygiene (poster WHO)
- “CleanHands” from Swissnoso
- Film about infection prevention (D)