Washing hands between patients is key to cutting infection rates

The National Patient Safety Agency has issued guidance saying the alcohol-based rubs should be offered throughout acute hospitals in England and Wales.

Hospital acquired infections include the superbug MRSA (methicillin resistant staphylococcus aureus).

They are estimated to kill at least 5,000 patients a year.

Even if we reduce infection rates by just 1%, this initiative would pay for itself many times over Julie Storr, National Patient Safety Agency 'I picked up a hospital infection'

Studies have shown rates fall between 10 and 50% when healthcare staff regularly clean their hands.

A six-month pilot of the 'Clean Your Hands' campaign in six hospitals showed staff increased their handwashing rate after contact with patients from an average of 28% of times to 76%.

An economic assessment of the campaign by the Department of Health estimates that if the success of the pilot is replicated, nationally 450 lives and �140million a year will be saved.

For a trust with 500 beds, it would cost between �2,500 and �3,000 to put supply all the beds with hand rub.

The NPSA says the cost of caring for just one patient with a severe hospital acquired infection would be much higher than that.

National campaign

Trusts are being advised they should implement the guidance by April next year, although the NPSA has no powers to enforce it.

However, it said around half of trusts had already begun introducing alcohol-based disinfectants at the point of care, and a further 20% were planning to do so.

There will also be a national publicity campaign encouraging NHS staff to wash their hands after caring for each patient.

A National Audit Office report in July criticised the NHS for failing to record comprehensive data on the number of infections seen in hospitals each year.

For example, the only kind of MRSA hospitals currently have to report is bloodstream infections, which increased from 7,250 in 2001-02 to 7,647 in 2003-04.

'Mass of barriers'

Launching the latest initiative to combat hospital infections, Health Minister Lord Warner said: "Tackling these infections has to be a major priority for all healthcare staff, as well as the government.

"Evidence from the pilot has shown us that by providing disinfectant hand rubs by each patient's bed, raising awareness generally and actively encouraging patients to ask staff if they have cleaned their hands, we can make a real impact for the benefit of all."

He defended the decision to give trusts until next April to comply with the new rules, saying that training staff and installing containers was a big task.

Julie Storr, NPSA project manager for the Clean Your Hands campaign, told BBC News Online: "Even if we reduce infection rates by 1%, this initiative would pay for itself many times over."

She added: "We know that staff are aware that they should clean their hands before and between every patient contact, but there are a mass of barriers to it happening in practice.

"A nurse in intensive care, for example, may be required to wash their hands 40 times in any one hour.

"We are confident that by raising staff awareness of the issue, making alcohol-based hand disinfectants easily accessible at the point of care and encouraging patients to ask staff if they have cleaned their hands, hand hygiene can be vastly improved to the benefit of patients."

Shadow Health Secretary Andrew Lansley said: "We welcome the efforts of NHS staff to reduce infection rates, through the new 'clean your hands' initiative.

"However, given nearly 5,000 die every year from hospital acquired infections, much more needs to be done."

He said the government had ignored NAO recommendations suggesting individual departments should take responsibility for their own infection rates.

"Instead hospitals are bound up in government red tape as infection control teams recommend changes that managers won't implement."