Translational Research in Hand Hygiene Compliance

Hand hygiene is considered to be the most important measure to prevent healthcare-associated infections, which represent a big concern in the world and are considered as priority by the World Health Organization, which proposed a multimodal strategy that has been implemented in several settings. However, many studies demonstrate that the overall compliance for hand hygiene practice remains low, and the most effective strategy or group of strategies are still unclear. We reviewed original articles reporting implemented strategies in order to improve hand hygiene adherence rates in healthcare services published in the last 2 years. Educational measures (like training, e-learning modules, feedback, and reminders), behavioral methods, electronic, radiofrequency and ultrasound methods, and patient empowerment strategies are discussed. We also discuss actions implemented in low-income countries where resources are limited. Most of the approaches presented in this article demonstrate they are effective in increasing hand hygiene adherence rates; on the other hand, sustainability of the results is difficult to achieve and vary according to local culture and resources. Although most of the reviewed articles are before-and-after studies and there is a paucity of high-quality studies, it seems that multimodal, continued interventions, and culture changes are essential to sustain high hand hygiene compliance rates.