I am back in the USA, back at work, preparing slides for my ID Week 2018 pro/con debate on hand hygiene tracking and monitoring.We hold hand hygiene sacrosanct in infection prevention. Some would argue that hand hygiene does not prevent infections, rather, it reduces the transmission of multi-drug resistant organisms, as explored here.
Regardless, it is safe to say that hand hygiene is potentially one of the most important infection prevention interventions and that compliance is generally suboptimal. A good systematic review and meta-analysis of interventions to promote hand hygiene can be accessed here.
Beyond that, things become contentious.
The proportionate impact of hand hygiene on infection prevention outcomes is debatable, there are no head to head trials comparing one multi-modal hand hygiene tracking strategy to another and certainly none comparing multi-modal strategies to the emerging hand hygiene electronic monitoring systems on the market.
What is the optimal level of hand hygiene compliance? At what point is there a diminishing return with improved hand hygiene and infection prevention outcomes? Which hand hygiene interventions are most reasonable and sustainable, so that they play out in the real world?
Simply put, our science (hospital infection prevention) lacks specificity.
So how much hand hygiene is enough? No one really knows but more is probably better.
Vexing.
