The effectiveness of interventions aimed at increasing handwashing in healthcare workers - a systematic review

Handwashing is widely accepted as being key to the prevention of hospital-a cquired infection but the frequency of handwashing by healthcare workers ha s been found to be low A systematic critical literature review was conducte d to establish the effectiveness of interventions aimed at increasing compl iance with handwashing in healthcare workers. The results showed that one-off educational interventions have a very short -term influence on handwashing behaviour. Use of strategically placed remin ders, or asking patients to remind staff of the need to conduct handwashing can have a modest but more sustained effect. Feedback of performance can i ncrease levels of handwashing but if feedback is not repeated regularly the n this effect is not maintained over long periods. Automated sinks increase the quality of handwashing but healthcare workers can be discouraged from using these because of the additional time involved. Provision of moisturiz ed soaps appears to make little difference to handwashing behaviour but pro viding 'dry' hand rubs near patient beds may lead to a minimal increase in the frequency with which staff decontaminate their hands, Multifaceted appr oaches which combine education with written material, reminders and continu ed feedback of performance can have an important effect on handwashing comp liance and rates of hospital-acquired infection. (C) 2001 The Hospital Infe ction Society.