HAI

Improving hand hygiene (HH) among healthcare workers (HCW) is currently the single most effective intervention to reduce the risk of healthcare associated infections in Australian hospitals. Although improving HH compliance seems an obvious and intuitive idea, changing attitudes and behaviour among HCWs in a healthcare system that for decades has not emphasised the importance of HH requires a major change in HCW culture and education. Instituting and sustaining culture-change among humans is always a challenging task, but recent Australian and international studies have shown that, given the right approach, Australian HCWs have readily adopted HH culture-change and the increased use of alcohol-based hand rub in their healthcare practice. These changes in attitudes and behaviour have resulted in a greater than 50% reduction in the rates of hospital acquired infection associated with methicillin-resistant Staphylococcus aureus (MRSA) and other multi-resistant pathogens in some States after just 1-2 years. Until recently, many Australian medical and nursing schools did not have education regarding alcohol-based hand rub and the importance of HH compliance as components of their curricula – clearly there is a lot to do in achieving sustainable HH culture-change. Nevertheless, a systematic approach can be taken with HH culture-change in which not only HCWs, but the entire Australian community, places a greater importance on good HH as a crucial means of controlling disease transmission. Excellent HH compliance needs to become one of the key indicators of whether a hospital delivers good healthcare and becomes an integrated feature of the Australian healthcare system.