Proper hand cleanliness is the easiest, the most efficient, and the most economical means of preventing nosocomial infections. Several studies have demonstrated that 55% of health care worker's hands are colonized by pathogenic bacteria that are easily transmitted among patients.

The hand cleanliness program implemented at the Le Gardeur hospital from 2003 to 2006 resulted in a 90% reduction in SARM infections. The program costs $179,000 annually but during the first year, the infection rate dropped by 50% and the hospital saved $811,000 in treatment costs.

Between January 2005 and April 2006, the Swiss government launched a hand cleanliness campaign in 116 hospitals and, as a result, reduced the nosocomial infection rate by 25%. Consequently, 17,000 patients avoided infection and the Swiss health care system saved the equivalent of $60 million dollars (CDN).

The commitment of health care workers to proper hand cleanliness is absolutely essential in preventing nosocomial infections. Sadly, doctors themselves are the most reluctant to practice basic hand cleanliness measures. In Switzerland only 60% of doctors maintained proper hand cleanliness during the first four months of the campaign. In comparison, 72% of other health care workers followed hand-washing procedure. Overall, there was a 33% increase in the number of health care workers who adhered to the hand washing policy.

Nurses are required to wash their hands 15 to 20 times an hour - roughly every 3 to 5 minutes - in order to maintain basic preventative measures. It takes approximately one minute to properly wash ones hands, not taking into account the "travel time" necessary to go to a sink. This corresponds to roughly two hours out of an eight-hour workday and therefore inhibits optimal efficiency. Consequently, it is recommended that health care personnel use an alcohol-based disinfectant to clean their hands. This procedure requires a mere 20 seconds and can be done while walking. Furthermore, it is imperative that the disinfectant be readily accessible. Disinfectant dispensers should be placed in close proximity to all hospital beds. Hospital personnel could also carry small pocket-sized dispensers of disinfectant with them throughout the day. It is also recommended that workers use a moisturizing cream in order to prevent skin dryness.

PROPER HAND CLEANING IN HOSPITALS

In order to ensure proper hand cleanliness among hospital personnel, the Swiss health care system implemented six basic measures:

• Hospital administrators and executives made hand cleanliness a top priority in their institutions.
• Hand cleanliness measures were standardized for all hospital personnel. Clear, written instructions are posted.
• A practical training seminar is mandatory for all health care personnel.
• Disinfectant solutions are placed with two meters of all hospital beds. It is simply not practical to expect hospital staff to constantly interrupt their work by going back and forth to washrooms or nursing stations in order to wash their hands.
• Administrators closely monitor hand cleanliness measures and keep track of the results. Following up on these measures is an excellent way to improve results.
• Reminders are posted at strategic points throughout the hospital such as patient's beds, washrooms, disinfectant dispensers etc