Hand hygiene and healthcare associated infections
Andrew McArdle and colleagues assess the importance of hand hygiene in controlling infections during delivery of health care
- By: Andrew McArdle, Jason Ali, Nicholas Brown
In 1847, Ignaz Semmelweis was house officer for a Viennese maternity ward that had a shocking mortality rate for maternal puerperal fever.1 His breakthrough was to realise that medical students and doctors were carrying the infection from autopsy specimens to patients. He instituted a policy of handwashing with chlorinated lime between autopsy and clinical work, and successfully reduced the mortality rate by a factor of five to a level comparable with that of the nearby midwives' maternity ward.
Today, healthcare associated infections are still a hugely important problem (see box 1 for types of infection). A 1995 study by the Department of Health showed that almost 8% of inpatients became infected in hospital.2 These patients had a 10% chance of dying (sevenfold higher than other patients) and stayed on average 14 more days in hospital, with added costs estimated at £3000 (€4400; $5900). The overall burden on the country has