Hand hygiene promotion: 5 moments, 5 components, 5 steps, and 5 May 2009

doi:10.3396/ijic.V5i1.001.09 Low staff compliance with hand hygiene practices remains a major problem in most healthcare settings worldwide. Indeed, when appropriate methodology is used to assess compliance, it rarely exceeds 30%.1 Successful hand hygiene promotion requires a multimodal strategy. Based on earlier experiences at single institutions and hospital networks,2-5 the World Health Organization (WHO) proposes an approach including at least five components: system change, in particular the recourse to alcohol-based hand rubbing as the standard of care, staff education using newly developed tools, monitoring and feedback of staff performance, reminders in the workplace, and promotion of an institutional safety climate.1,2 A five-step implementation strategy and related tools are proposed and have been tested in a large number of healthcare settings in both limited and high resource countries.6 Early results are extremely encouraging. The findings by Chittaro and colleagues in this issue of the Journal are of interest. The authors observed hand hygiene practices immediately (at seven and 30 days) after the introduction of alcohol-based hand rub in thre