What can Public Health Departments do to Improve Hand Hygiene in Hospitals?

Background: Compliance with hand hygiene in hospitals often needs improvement. Public health departments should support the hospitals in implementing good hand hygiene. This may be achieved by assessing the consumption of hand disinfectant and discussing the results with the hospitals. Material and Methods: In the course of routine infection control visits, the Frankfurt public health department asked for the data on the consumption of hand disinfectant in the hospitals. In 2004, overall consumption of the hospitals was asked for, in 2005 consumption in all parts (wards, operating units, endoscopy units, ambulances etc.) was obtained, completed by the data of patients per day and ward in 2006 in some of the hospitals. Results: As expected, larger hospitals exhibited higher overall hand disinfectant consumption. With respect to the number of hospital beds available, the differences were no longer significant. In the various hospitals, 27-64% of the overall amount of hand disinfection was used in wards, 17-57% in operative units, and 3-20% in other areas. Assessment of disinfection consumption in 120 wards, covering 709 339 patient days, resulted in great differences between intensive care units (median 97 ml/patient and day) and non-intensive units (adults 18 ml/patient clay, children 41 ml/patient day). Discussion: Controlling data on the consumption of hand disinfectant is easily possible. By demanding and discussing these data in the course of their routine hygiene control visits, the public health departments should emphasise the importance of hand hygiene as an effective method for preventing nosocomial infections. In addition, the hospitals should be encouraged to take part in the "Clean Hands Action", the German branch of the WHO campaign "Clean care is safer care".