Clinical Care

We must fix our falling hand-hygiene rates

When HH figures drop, a rise in hospital-acquired and surgical-site infections is sure to follow.


In 2016, the percentage of Asante staff performing hand hygiene when entering and leaving patient rooms neared 100%. In fact, AACH regularly achieved 100% adherence month after month, and ATRMC was a close second at 99%.

Fast-forward to 2021 and 2022 and the numbers are disheartening. In 2021, hand-hygiene compliance averaged 81% across our three hospitals. We’re below even that this year.

Yes, the ongoing pandemic and the effects of staffing shortages are taking their toll. We’re busy taking care of patients. Yet the hands that help care for our patients can also be infection vectors. And keeping them clean is just as important as donning PPE or wearing a mask.

When it comes to hospital-acquired infections, hand hygiene is a leading indicator. When staff members fail to wash their hands or use an alcohol-based rub, an HAI is more likely to follow as illustrated by these charts.

Hand hygiene


The red line indicates hand-hygiene compliance systemwide. To prevent hospital-acquired and surgical-site infections, HH adherence should be 100%.

Staff should always perform hand hygiene:

  • Before and after donning and doffing PPE.
  • Before direct contact with patients.
  • Before entering and after leaving a patient’s room.
  • Before performing a clean/aseptic procedure.
  • After contact with a patient and after touching the patient’s surroundings.
  • After contact with body fluid.
  • After cleaning the immediate environment or dedicated medical equipment.

Remember, you must use soap and water if your hands are visibly soiled, before eating and after using the restroom. You must also wash with soap and water when caring for a patient with a C. difficile infection or after a suspected exposure to Bacillus anthracis (the organization that causes anthrax).

It’s time to remember what we understood in 2016: Clean hands for every patient, every time.

Tags: HAI, Hand hygiene, Holly Nickerson, hospital-acquired infection, STAT, surgical site infection
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If you have a question, please contact the author or relevant department directly.

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