Paper supports focus on hospitals’ hand hygiene

11 May 2012 | Infection Prevention & Control

A paper [1] published today in the New Zealand Medical Journal supports a focus on improving hand hygiene in hospitals to reduce hospital-acquired infections.

Implementation of the Hand Hygiene New Zealand (HHNZ) programme began at Auckland District Health Board (DHB) in January 2009. Health care workers in each ward and clinical area were provided with information about hand hygiene, including the World Health Organization’s ‘5 moments of hand hygiene’.

An evaluation of the programme after 36 months found compliance with hand hygiene requirements rose from 35 to 60 percent. During this time there was a reduction in the rates of the bloodstream infection Staphylococcus aureus bacteraemia.

Health Quality & Safety Commission Chief Executive, Dr Janice Wilson, says the Auckland DHB study demonstrates the benefits to patients from an increased focus on hand hygiene in our hospitals. The Commission partners with Auckland DHB to deliver the Hand Hygiene New Zealand programme [2].

“Hand hygiene is one of the most important measures in the fight against health care-acquired infections, making it a key patient safety issue within the health sector.

“We know from international evidence that improved hand hygiene practices help reduce health care-acquired infections, including antibiotic-resistant infections within hospitals.

“This study adds to the growing weight of evidence that having clean hands before and after contact with patients is one of the most important things health care workers can do to prevent infections. It also supports continued work with hospitals to increase compliance with hand hygiene measures.

Clinical Lead of the Hand Hygiene New Zealand programme, Dr Joshua Freeman, also supported these views and added that reports such as this highlight the value of DHBs investing in local hand hygiene programmes, but stated that to be most effective, support is required from senior leadership.

“Effecting hand hygiene behaviour change requires not only a sustained awareness programme, but it requires the full backing and support from senior leadership within each DHB.”

The WHO estimates millions of patients around the world are affected by infections acquired in health care settings. These infections contribute to deaths and disability, promote resistance to antibiotics, complicate the delivery of patient care, and impose extra costs on health systems.

The WHO has identified five key moments when health workers should perform hand hygiene:

  1. before patient contact
  2. before a procedure
  3. after a procedure or body fluid exposure
  4. after patient contact
  5. after contact with patient surroundings


 [1] Implementing and sustaining a hand hygiene culture change programme at Auckland District Health Board. Sally Roberts, Christine Sieczkowski, Taima Campbell et al. NZMJ 11 May 2012, Vol 125 No 1354.

 [2] Hand Hygiene New Zealand (HHNZ) is one of three components of the Health Quality & Safety Commission’s Infection Prevention Control programme, which aim to improve patient safety by reducing healthcare associated infections. See for more information.

Last updated 30/07/2018