More hand-washing won't curb hospital infections

Although hand hygiene is an important method of hospital infection control, increasing the frequency of hand washing by doctors and other healthcare workers does not necessarily result in commensurate reductions in staphylococcal infections, according a new study.

"While it is undoubtedly the case that improved hand hygiene is beneficial, there is growing evidence that increased compliance may not yield the hoped-for results," Dr. Kevin G. Kerr, of Harrogate District Hospital, and colleagues note in the latest issue of the online journal BMC Infectious Diseases. The results of several studies suggest that the "law of diminishing returns" applies to hand hygiene, with the greatest benefits occurring with the first 20 percent of compliance.

Based on their research, Kerr and colleagues conclude that under most circumstances, it should be possible to prevent outbreaks of staphylococcal infection from occurring with a hand cleansing frequency of approximately 40 percent.

In addition, their research shows that the relationship between hand cleansing efficacy and frequency is not linear. This suggests that it is important to maximize the efficacy of hand cleansing because this will reduce the amount of hand washing activity necessary to prevent an outbreak from occurring.

Based on these results and those of earlier studies, "it can therefore be concluded that it should be possible to prevent many outbreaks of staphylococcal infection through hand hygiene measures alone, even if high compliance rates are not achieved," Kerr's team states.

"In the study reported here it appears that compliance rates of 40 percent or so should be adequate to prevent most outbreaks occurring," they note. However, "this raises questions as to why so many outbreaks of staphylococcal infection continue to occur, despite the fact that recorded hand hygiene compliance rates are generally in the region of 40 percent."

SOURCE: BioMedCentral Infectious Diseases, 2008.