We have provided answers to some of the questions frequently asked about the campaign. If these do not provide the information you require please contact our team
Q. Is hand hygiene as important as this campaign suggests?
A. Hand hygiene is one important component in the battle against healthcare associated infection (HCAI). Minimising risks of infection to patients depends on a range of factors. However, just by increasing staff compliance with hand hygiene at the point of care you can dramatically reduce the risk of a patient acquiring a healthcare associated infection. This is supported by scientific evidence, not just opinion, which demonstrates that the microorganisms that cause healthcare associated infections are most frequently spread from one patient to another on the hands of healthcare staff.
A. There are many reasons: lack of sinks, activity levels on the wards/departments, staffing levels, staff perceptions about soap and its irritant effects, lack of role models, lack of organisational support for hand hygiene - to name but a few. All of these reasons add to the low internal motivation which staff have for performing timely and effective hand hygiene. The NPSA cleanyourhands campaign, of which near-patient alcohol handrub is one part, is designed to go some way to helping organisations address a range of the reasons for low compliance.
Q. What sort of microorganisms does hand cleaning stop from spreading?
A. The type of microorganisms which can be spread by the hands of staff include Staphylococcus aureus (including MRSA), Streptococcus pyogenes (Group A Strep), Clostridium difficile, Norovirus, Klebsiella, Enterobacter, and Pseudomonas.
Wounds will contain large numbers of microorganisms, and large numbers can also be found on other areas of the skin.
Staff hands can pick up microorganisms even after seemingly ‘clean’ procedures such as taking a pulse, taking blood pressure readings, taking a temperature, touching a patient’s hand.
A.Yes. It is a simple concept, but ultimately improving hand hygiene compliance will help to save lives.
A. No. Handwashing plays a vital role in hand hygiene and is always recommended if your hands are visibly soiled, if caring for a patient with diarrhoea or vomiting, if working in an area where there is an outbreak of diarrhoeal disease, including Clostridium difficile or Norovirus and if hands have come in contact with body fluids.
The alcohol handrubs make it easier for staff to clean their hands quickly with a minimum amount of effort and skin irritation, which is why they are recommended for routine use where none of the above indicators for handwashing occur.
A. The objective of the cleanyourhands campaign is to get staff to clean their hands at the point of care, as this is where there is the greatest risk of transferring the microorganisms that cause infection. Some organisations have chosen to site dispensers for alcohol handrub at the entrances to wards and buildings where they can be used by everyone as they enter and leave. These may help to limit microorganisms being brought in from outside and will often help to raise awareness of hand hygiene in general, but as they are not normally accessible from the point of care they are of limited use to staff.
A. Promoting use of alcohol handrub to patients/service users and visitors is a decision for NHS trusts locally. The campaign supports the involvement of patients/service users in improving the hand hygiene of staff.
The phrase ‘it’s ok to ask’ is included on some of the campaign materials, and is intended to invite rather than oblige patients/service users to remind staff about hand hygiene.
This is supported by the original pilot for the campaign in hospitals, which found that 71% of patients and visitors were interested with being involved with hand hygiene improvement.
A. No.Promoting hand hygiene among visitors and patients/service users might be seen as a way of raising the profile of hygiene per se – but it is unlikely that this will impact on the rates of healthcare associated infection. Healthcare staff – not visitors, patients or service users – are the ones with the greatest potential to transmit microorganisms. Increasing hand hygiene compliance amongst staff remains the focus of the cleanyourhands campaign.
Whilst visitors to patients/service users come into contact with the patient environment it is very rare that they have regular and prolonged contact with patients/ service users. It is important to note how extremely unlikely it is that visitors will touch patients/service users in susceptible areas of the body – and even more so that they might need to move to touch other patients/service users and do the same. It is the hand hygiene of healthcare staff that we need to be monitoring and supporting – not visitors’ and patients/service users.
A. The cleanyourhands campaign focuses on the hand hygiene of healthcare staff, however we do not wish to discourage patients/service users or visitors from observing good personal hygiene.
Their awareness of the importance of hand hygiene in the drive to reduce healthcare associated infections is a key aspect of the cleanyourhands campaign. However, we must be clear about the critical role of visitors and patients/service users in supporting improvement:
- to expect to see the correct behaviour on the part of healthcare staff;
- to choose – if they wish – to support and work with organisations/staff to achieve excellence in achieving behaviour change through forums and other channels;
- on the part of patient/ service user, or carers of children or patients/ service users unable to communicate easily themselves: to minimise the risks of HCAI to themselves by asking if or when the correct behaviour is not visible on the part of staff.
We promote and encourage patient/ service user involvement by making it clear to them that it’s OK to ask.