Hand washing

A modest measure—with big effects

Hospital acquired infection damages patients, prolongs hospital stays, consumes scarce hospital resources, and thus presents a major challenge for clinical governance.1 In a seminal intervention study 150 years ago Semmelweis insisted that doctors performing necropsies washed their hands before delivering babies, so reducing mortality due to streptococcal puerperal sepsis from 22% to 3%.2 Many studies since have confirmed that doctors decontaminating their hands between seeing patients can reduce hospital infection rates.3 Nevertheless, healthcare workers still fail to wash their hands and fail to appreciate the importance of doing so.3 This month the Department of Health has had another attempt at reminding them by sending a document and health circular to all NHS chief executives, public health directors, and microbiologists in England.

Many observational studies, mainly conducted in intensive care units, show low rates of hand washing, especially among doctors.4 Bartzokas et al observed that, despite frequent …