Hand hygiene

The evidence for clean hands

The problem

Each year, hundreds of millions of patients around the world are affected by health care-associated infections (HAIs). Although HAI is the most frequent adverse event in health care, its true global burden remains unknown because of the difficulty in gathering reliable data. Understanding and assessing the global burden of HAI is one of the key areas of work of the IPC team at WHO. Systematic reviews of the literature were conducted to identify published studies from both developed and developing countries and highlight the magnitude of the HAI problem. In 2010-11, WHO published a scientific article and a global report on the burden of endemic health care-associated infection worldwide. In 2020, WHO published a global report on the epidemiology and burden of sepsis, which includes a new section on health care-associated sepsis.

The solution

Most HAIs are preventable through best hand hygiene practices – cleaning hands at the right times and in the right way. The WHO Guidelines on hand hygiene in health care support hand hygiene promotion and improvement in health-care facilities worldwide and are complemented by the WHO Multimodal hand hygiene improvement strategy, the Guide to implementation, and an implementation toolkit, which contains many ready-to-use practical tools. The WHO multimodal hand hygiene improvement strategy has been shown as the most effective approach leading to practices improvements. Hand hygiene improvement programmes can prevent up to 50% avoidable infections acquired during health care delivery and generate economic savings on average 16 times the cost of implementation.