Prevailing over dirt: compliance with hand hygiene in hospital settings

Infectious risks in hospital environments present a particular paradox. Because nosocomial infections blur the boundaries between care-givers and patients, between the normal and the pathological, they threaten the physical health and the professional identity of the very people who are supposed to prevent them. At the University Hospitals of Geneva, 38 health-care professionals recount their resistance to the observance of the strict hand hygiene protocol when it interferes with patient contact. The dual constraint that requires of care-givers to maintain an aseptic contact with patients as well as a good relationship with them shifts the problem of observance to an area that is more social than medical and more ritual than technical.