Hand Hygiene – Focus on surgical patient care

Hospital acquired infections (HAI) and antimicrobial resistance represent a serious threat to patient safety and healthcare systems globally and especially in our country. Hand hygiene (HH) promotion seems to be the cornerstone of infection control interventions as it is the most important measure to prevent transmission of pathogens by healthcare workers (HCWs). There is clear evidence that strict adherence to HH reduces the risk of cross-transmission. HH practices are well known, however, compliance is low and many factors (cultural and behavioral issues among them) have been implicated. Behavioral change seems to be crucial for improving HH compliance, though is quite difficult to be achieved and requires multifaceted techniques. World Health Organization (WHO) proposes a layered strategy to improve compliance. In 2005, WHO launched the first global HH campaign. The primary focus of 2016 WHO's campaign is the surgical patient's care, as proper implementation of HH significantly contributes to the reduction of surgical site infections (SSIs). SSIs are quite prevalent, especially in middle and low-income countries and they have important impact on patients' outcomes. Their prevention is complex, multimodal, multi-disciplinary and rather challenging. The key risk factor for SSIs is the poor adherence and incorrect HH procedures during perioperative and postoperative care. Surgical hand disinfection procedures include surgical scrub and surgical rub. According to current guidelines, both methods are considered suitable, though several factors favor the use of hand rub, including rapidity of action and thus time savings and fewer side-effects. Improving hand hygiene practices in all surgical services is the leading prevention measure to make surgery safer worldwide.