Hand Hygiene Adherence for Hospital-Acquired Infections Prevention


Hospital-acquired infections (HAIs) are a cause of significant morbidity and mortality among patients in primary and intensive care units. Moreover, HAIs are associated with an increased cost of care for patients, hospitals, and the healthcare system in general. According to King et al. (2016), a substantial number of HAIs occur due to the transmission of microorganisms in the hands of care providers.

Therefore, our hospital has a program of improving compliance with hand hygiene standards. The program includes continuing education and provision of dispensers with alcohol-based hand rub at the point of care, which is crucial, according to Thi Anh Thu (2015). The program meets all the benefits of evidence-based practice (EBP) since it is an efficient method that benefits all the stakeholders.

Quality and Cost of Care

Simple adherence to hand hygiene standards is a vivid example of how EBP can reduce the cost of care and improve its quality. First, the quality of care has improved since the number of HAIs was decreased significantly after the adaptation of the program. According to Thi Anh Thu (2015), effective hand hygiene programs can reduce the amount of HAIs by 36 percent, which is closely associated with improved patient outcomes and increased quality of care due to the decreased number of complications. Second, the reduced count of HAIs is also associated with a lower cost of care since HAIs are associated with high readmission rates and increased inpatient days (Rahmqvist, Samuelsson, Bastami, & Rutberg, 2016).

According to Cohen, Liu, Cohen, Larson, and Glied (2018), hospitals pay 71% of excess costs associated with HAIs since third-party payers, such as Medicaid and insurance companies, do not cover the cases of HAIs. Such policies from third-party payers are based on the incentive that patients and other stakeholders should not pay for the mistakes of care providers. Therefore, efficient hand hygiene compliance programs are associated with improved patient outcomes, which is closely correlated with a decreased number of complications, payment denials, and overall cost of care.

Role Satisfaction and Turnover

Even though there are no direct links between hand hygiene practices and role satisfaction and turnover rates, there indirect relationships among those matters. As was mentioned above, an increased number of HAIs is closely associated with higher readmission rates and more extended patient stay. Due to these factors, the care providers’ workload also increases. According to Welp, Meier, Manser (2015), increased workload leads to emotional exhaustion, which is often a reason for low role satisfaction, increased turnover rates, and adverse patient outcomes. Even though no research studies correlation between hand hygiene compliance and role satisfaction or turnover rates, critical analysis confirms that there is a connection.

Geographic Variations and Public Satisfaction

A hospital’s acceptance of hand hygiene standards recommended by the World Health Organization (WHO) reduces geographic variations of the provision of care. Additionally, since WHO is an authoritative organization, the use of its standards can also be associated with the expectations of the informed public. Moreover, improved patient outcomes and role satisfaction for healthcare providers may positively influence patient satisfaction with the provision of care.


Interventions for increasing hand hygiene compliance among care providers are an excellent example of EBP. It demonstrates that small changes in practice based on evidence can positively affect the experience of all stakeholders. In particular, acceptance of WHO hand hygiene standards can enhance the quality of care, decrease its cost, and improve patient satisfaction.


Cohen, C., Liu, J., Cohen, B., Larson, E., & Glied, S. (2018). Financial incentives to reduce hospital-acquired infections under alternative payment arrangements. Infection Control & Hospital Epidemiology, 39(5), 509-515. Web.

King, D., Vlaev, I., Everett-Thomas, R., Fitzpatrick, M., Darzi, A., & Birnbach, D. J. (2016). “Priming” hand hygiene compliance in clinical environments. Health Psychology, 35(1), 96–101. Web.

Rahmqvist, M., Samuelsson, A., Bastami, S., & Rutberg, H. (2016). Direct health care costs and length of hospital stay related to health care-acquired infections in adult patients based on point prevalence measurements. American Journal of Infection Control, 44(5), 500–506. Web.

Thi Anh Thu, L., Thi Hong Thoa, V., Thi Van Trang, D., Phuc Tien, N., Thuy Van, D., Thi Kim Anh, L., … Truong Son, N. (2015). Cost-effectiveness of a hand hygiene program on health care–associated infections in intensive care patients at a tertiary care hospital in Vietnam. American Journal of Infection Control, 43(12), e93–e99. Web.

Welp, A., Meier, L., & Manser, T. (2015). Emotional exhaustion and workload predict clinician-rated and objective patient safety. Frontiers in Psychology, 5. Web.