Handwashing and infections

In May 1847, Ignaz Philipp Semmelweis (1818–1865) showed by experiment that handwashing could prevent infections (Noakes et al, 2008). He instigated a hand-washing regime at the maternity clinic of the Vienna General Hospital, where monthly maternal mortality rates from puerperal fever (caused by group A beta-haemolytic Streptococcus) were as high as 20%. The following month, mortality on the labour ward was 1.2%.

Despite this early evidence of the effect of handwashing on infection, as Dr Atul Gawande (2004: 1285) observed: ‘The Journal of Hospital Infection and Infection Control and Hospital Epidemiology… read like a sad litany of failed attempts to get us to change our contaminating ways.’ Data from the World Health Organization (WHO) show an apparent continuing failure of health-care workers (HCWs) to protect their patients. When the WHO (2009: 5) reviewed 77 hand-hygiene peer-reviewed articles from 1981–2008, it reported: ‘Adherence of HCWs to recommended hand hygiene procedures has been reported as variable, with mean baseline rates ranging from 5% to 89% and an overall average of 38.7%.’