Practical Issues in HH Compliance and Solutions

WHO Collaborating Centre for Infectious Diseases Surveillance and Control, School of Public Health, the University of Hong Kong. Hong Kong SAR China

Hand hygiene continues to be considered one of the most important methods of preventing transmission of healthcare-associated pathogens and reducing the incidence of healthcare-associated infections. Issues in recent years continued to challenge in achieving desired levels of hand hygiene compliance and appropriate hand hygiene technique including effective monitoring hand compliance and providing effective feedback to healthcare personnel (HCP).

The lag in achieving maximum results in hand hygiene compliance are multifaceted including the inconvenience of hand hygiene infrastructure, poor budget allocation, absence of hand hygiene supplies, absence of practical guidelines, poor awareness, attitudinal challenges, lack of time, poor monitoring and evaluation.

Behavioural factors like cognition, attitude and perceived barriers significantly influences adherence to hand hygiene among healthcare personnel such as inconvenience hand washing facilities due to the poor design of healthcare facilities. This can be solved by attitudinal, leadership, and policy-related issues. Physical discomforts like skin allergies and irritation, filling of sensation, and bad odour significantly affect healthcare providers’ adherence with hand hygiene. These barriers identified are interconnected and reinforced one another, where behavioural barriers are fuelled by organizational limitations and societal factors

Hand hygiene compliance among HCPs is intertwined and complex, with the interplaying among behavioural, societal/interpersonal, physical, and organizational barriers. These barriers require a multifaceted approach that focuses on education & training, improving access to favoured hand hygiene resources, require involving relevant stakeholders to improve hand hygiene adherence. Focusing on the development and implementation of hand hygiene guidelines, professional programs, fostering a supportive workplace culture, and implementing effective resource mobilization by management strategies coupled with supportive supervision, monitoring, evaluation, and feedback is critical to tackle the problem.