Hand hygiene in the healthcare environment

Hands are one of the main pathways for germ transmission within healthcare and the community. Effective hand hygiene is one of the most effective measure to prevent the spread of infections.

There are around 165,000 healthcare associated infections nationally each year, making this the most common healthcare complication affecting patients in hospital.

Effective hand hygiene can significantly reduce the rate of healthcare associated infection and hospital-acquired complications (HACS).

As per the mandatory Australian Commission on Safety and Quality in Health Care (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards Preventing and Controlling Infection Standard hand hygiene action item, health service organisations are to support the implementation of a hand hygiene program that is consistent with the National Hand Hygiene Initiative (NHHI).

Hand hygiene education is available for all healthcare workers, for information visit the Infection prevention and control (IPC) education page.

National Hand Hygiene Initiative

As part of the World Health Organisation's First Global Patient Safety Challenge, the Australian Commission on Safety and Quality in Health Care (ACSQHC) established the National Hand Hygiene Initiative (NHHI) in 2008 to prevent and reduce healthcare-associated infections in Australian healthcare settings.

The NHHI uses a multi-modal approach to improving hand hygiene and includes:

• alcohol-based hand rub at the point-of-care
• ensuring consistent hand hygiene and infection prevention and control education
• monitoring hand hygiene compliance and performance feedback
• using hand hygiene programs that ensure culture change.

Compliance with hand hygiene according to the WHO '5 moments for hand hygiene' is recorded by trained and validated auditors. Hospitals are required to submit data according to the NHHI schedule and SA Health Performance framework and key performance indicators. The number of 'moments' required to be audited is proportional to the size of the hospital.

Facilities not meeting the requirements for national data submission may choose to utilise the SA Health observational audit tool (PDF 196KB) to estimate overall hand hygiene compliance and is in keeping with the 5 Moments for hand hygiene.

The SA Health hand hygiene competency tool (PDF 87KB) has been developed to assess staff competency in carrying out an effective hand hygiene rub or handwash.

South Australia

As per the NHHI, each hospital or Local Health Network (LHN) should have a Hand Hygiene Program Coordinator who is responsible for the governance and oversight of local hand hygiene programs.

LHN contacts

For queries related to the NHHI, refer to the ACSQHC NHHI website or contact your LHN Hand Hygiene Program Coordinator:

• Central Adelaide Local Health Network — health.calhninfectionpreventionandcontrolunit@sa.gov.au
• Northern Adelaide Local Health Network — health.mhinfectioncontrol@sa.gov.au
• Southern Adelaide Local Health Network — health.salhninfectioncontrol@sa.gov.au
• Women's and Children's Health Network — health.wchninfectionpreventionandcontrol@sa.gov.au
• Rural Support Services (RSS) and regional LHNs — health.rssinfectioncontrol@sa.gov.au.

SA Health guideline

The associated SA Health Hand Hygiene Guideline (PDF 223KB) summarises best practice for healthcare workers in the clinical setting.

Hand hygiene compliance rates

Hand hygiene compliance is assessed against a national benchmark agreed to by all states, territories and the Commonwealth. The state and national benchmark is 80%. The latest hand hygiene audit data and previous reports can be viewed via the National Hand Hygiene Audit Dashboard.

The Australian Institute of Health and Welfare reports hand hygiene compliance for each audit period for public hospitals at national, and individual hospital levels, as well as by hand hygiene moment and healthcare worker group. SA Health identifies hand hygiene as a performance framework and key performance indicator.

Selection of alcohol-based hand rubs

For information regarding the use and selection of alcohol-based hand rubs, refer to the ACSQHC's Australian Guidelines for the Prevention and Control of Infection in Health Care.

Resources and sustainable IPC information

The following resources have general information on hand hygiene, the appropriate use of gloves in healthcare and how to support environmentally sustainable infection prevention and control practices:

• Gloves do not replace hand hygiene poster (WHO) (PDF 59KB)
• Practice hand hygiene and use gloves appropriately poster (PDF 58KB)
• Sustainable glove use for healthcare workers fact sheet (ACSQHC) (PDF 204KB)
• Case study: Hunter New England (HNE): Gloves off! campaign
• Wash, Wipe, Cover (SA Health)
• National Hand Hygiene Initiative resources
  

Click on the below images to download the relevant poster.

The ACSQHC has a range of promotional materials to support the improvement of hand hygiene in Australia.

World Hand Hygiene Day

World Hand Hygiene Day on 5 May is part of a major global effort led by the World Health Organization (WHO) and supported by SA Health annually. This day aims to support health-care workers to improve hand hygiene in healthcare and accordingly support the prevention of life-threatening healthcare associated infection (HAI). 

Information on the latest campaign can be found on the WHO hand hygiene and ACSQHC World Hand Hygiene Day webpages.

Further information

For further information on hand hygiene contact SA Health Infection Control Service on (08) 7425 7161.