JULES STORR

Hand hygiene has had a high prominence in the context of COVID-19 during the past year. World Hand Hygiene Day, celebrated each year on the 5 May, and led by the World Health Organization (WHO), presents an annual opportunity to keep this important patient safety intervention firmly on the international and national agenda beyond a global pandemic. This year we are prompted not to forget the critical times for hand hygiene, and particularly the valuable role that healthcare workers and all those who support them play, in achieving effective hand hygiene action at the point of care. Campaigns play many roles, not least an important one in sustainability,[1] periodically boosting interest and focus on an issue of concern, in this case hand hygiene in healthcare. They prompt their stakeholders to remember important things that can get overlooked in the day to day noise. This year’s theme builds on the 2020 COVID-19 driven call for universal hand hygiene.[2] However, while COVID-19 placed a spotlight on hand hygiene like never before, other infectious diseases are still out there (including those resistant to antibiotics). As a public health problem, one of the last published global reports highlighted that healthcare-associated infections constituted the most frequent adverse event in healthcare.[3] These infections continue to cause harm and death in hospitals and other care settings across the world, destroying too many lives. Hand hygiene at the right moment[4] is therefore a powerful intervention to stop their spread and historically was referred to as the single most important measure in infection prevention and control. But I do like the emerging mantra of Do It All. Hand hygiene is in fact often one of many interventions that when undertaken reliably and at the right time keep people safe. We should perhaps gravitate more towards this way of framing and embedding hand hygiene (and other activities and interventions). COVID-19 is a great example of the need for integrated and synergistic action. Measures that protect people from harm and keep them safe should not be pitched in competition with each other, and those involved must collaborate for greatest impact. In a previous blog post[5] I recalled an excellent piece in the New Yorker by Michael Specter written on the back of the Ebola outbreak of 2014/15.[6] In it he reflected on our response to pandemics: “First, there is the panic. Then, as the pandemic ebbs, we forget. We can’t afford to do either.” We should not forget anything about this pandemic. Hand hygiene in healthcare is one small but important part of keeping people safe. As WHO state, yes we should “do it all”, and yes, hand hygiene at the point of care is important and should be a constant feature of safe, high quality healthcare. We shouldn’t forget that. This and every World Hand Hygiene day helps to make sure that we don’t. References Mathai E, Allegranzi B, Kilpatrick C et al. Promoting hand hygiene in healthcare through national/subnational campaigns. J Hosp Infect 2011:77(4):294-8. doi: 10.1016/j.jhin.2010.10.012. WHO. Recommendations to Member States to improve hand hygiene practices to help prevent the transmission of the COVID-19 virus. Interim guidance. 1 April 2020. WHO. Report on the Burden of Endemic Health Care-Associated Infection Worldwide. Clean Care is Safer Care. 2011. WHO. Your 5 moments for hand hygiene. 2009. Kilpatrick C, Storr J. The 13,268. SafeSaferSafest. 8 November 2014. Specter M. The fear equation. The New Yorker. 12 October 2014.