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Hospital-acquired infections (HAIs) constitute a significant burden on health and health
systems. Handwashing is accepted widely as being one key way to prevent HAIs but the
frequency of handwashing by healthcare workers has been found to be low.
A number of interventions including education, performance feedback, modifying hand
basins and soap, and multifaceted combinations of approaches have been evaluated to
improve handwashing compliance among healthcare workers.
Key messages
 Adequate facilities (clean water, soap and functioning sinks) are a prerequisite for
interventions to increase handwashing among healthcare workers
 Where facilities exist, multifaceted approaches combining education, reminders and
continued feedback on performance can have a beneficial effect on handwashing
compliance and rates of HAI. The effects of these interventions may be sustained
though evidence for this is limited.
 Single interventions are less successful. The best single approaches appear to be
performance feedback and strategically placed reminders.
 The quality of evidence on the effect of interventions to increase handwashing is
generally very low.


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