DÄ internationalArchive8/2010Hand Hygiene Prevents MRSA Transmission
LNSLNS The discovery that disinfecting hands reduces transmission of pathogens is a cornerstone of modern medicine and a crucial quality parameter in the healthcare system. Improving hand hygiene is obligatory for all institutions. We therefore are at a loss to understand why many parties in Germany have chosen not to participate in the national clean hands campaign, “Aktion saubere Hände.” At University Medical Center Freiburg we have observed that linking hand hygiene with skin protection/skin care, as was implemented in collaboration with the occupational health services and the Department of Dermatology, has yielded enormous improvements. Health care workers’ hands are the crucial tools of the trade where treating patients is concerned—hands have to protect patients, but in turn they have to be protected themselves. Additionally, we switched to colouring- and perfume-free products for hand hygiene, because the colouring and perfume in such preparations do not contribute to a product’s effectiveness or tolerability and may even trigger sensitization. Even if skin problems due to hand hygiene are usually caused by irritant-toxic damage, the risk for contact allergies should also be reduced (2). After the switch we again observed a substantial increase in the use of alcohol-based hand rub in our institution—additionally promoted by a series of measures to improve hand hygiene, such as short training sessions, improved access to dispensers, complemented use of wearable dispensers—for example, for transport services. In a recent study, we have shown that increased use of alcohol-based hand rub helps prevent transmission of nosocomial MRSA (3). In addition to improving the quality of medical treatment and patient safety, we were thus able to reduce the time, money, and effort spent on delivering health care.
DOI: 10.3238/arztebl.2010.0139a

Prof. Dr. med. Markus Dettenkofer
Dr. med. Andreas Conrad
Institut für Umweltmedizin und Krankenhaushygiene,
Universitätsklinikum Freiburg
Breisacher Straße 115B, 79106 Freiburg, Germany
andreas.conrad@uniklinik-freiburg.de

Conflict of interest statement
Professor Dr Dettenkofer and Dr Conrad have received honoraria for speaking from B. Braun Melsungen AG and Schülke & Mayr GmbH. The Department of Environmental Health Sciences at the University Medical Center Freiburg have conducted studies financially supported by B. Braun Melsungen AG, Ecolab Deutschland GmbH and Schülke & Mayr GmbH.
1.
Kampf G, Löffler H, Gastmeier P: Hand hygiene for the prevention of nosocomial infections [Händehygiene zur Prävention nosokomialer Infektionen]. Dtsch Arztebl 106(40); 649–55. VOLLTEXT
2.
Conrad A, Poser I, Wenzler-Röttele S, Dettenkofer M: „Wir haben es in der Hand!“ – farbstoff- und parfümfreie Händehygiene. Umweltmedizinischer Informationsdienst (UMID) 2007; 3: 24–26.
3.
Kaier K, Hagist C, Frank U, Conrad A, Meyer E: Two time-series anal-yses of the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant Staphylococcus aureus infection and Clostridium difficile infection. Infect Control Hosp Epidemiol 2009; 30: 346–353. MEDLINE
1. Kampf G, Löffler H, Gastmeier P: Hand hygiene for the prevention of nosocomial infections [Händehygiene zur Prävention nosokomialer Infektionen]. Dtsch Arztebl 106(40); 649–55. VOLLTEXT
2. Conrad A, Poser I, Wenzler-Röttele S, Dettenkofer M: „Wir haben es in der Hand!“ – farbstoff- und parfümfreie Händehygiene. Umweltmedizinischer Informationsdienst (UMID) 2007; 3: 24–26.
3. Kaier K, Hagist C, Frank U, Conrad A, Meyer E: Two time-series anal-yses of the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant Staphylococcus aureus infection and Clostridium difficile infection. Infect Control Hosp Epidemiol 2009; 30: 346–353. MEDLINE