Nurses had the highest compliance rates at 71 percent across all sites -- at 43 hospitals in Costa Rica, Italy, Mali, Pakistan and Saudi Arabia -- before the intervention and after the intervention.
The intervention, the WHO Clean Care is Safer Care Program, explains to doctors, nurses and all those working with patients that hand hygiene should be performed at five key moments, preferably by using an alcohol-based rub or by hand washing with soap and water if hands are visibly dirty.
The five moments for hand hygiene are:
-- Before touching a patient.
-- Before clean and aseptic procedures such as inserting devices into the body such as catheters.
-- After contact with body fluids.
-- After touching a patient.
-- After touching patient surroundings.
Healthcare-associated and hospital-acquired infections usually occur when germs are transferred by healthcare providers' hands touching the patient. The most common infections are urinary tract and surgical site infections, pneumonia and infections of the bloodstream. They are often caused by multi-drug resistant germs such as methicillin-resistant S. aureus.
Of every 100 hospitalized patients, at least seven in developed and 10 in developing countries will acquire a healthcare-associated infection.
However, among critically ill and vulnerable patients in intensive care units, that figure rises to about 30 per 100. Practicing good hand hygiene during healthcare reduces the risk of these infections and the spread of antimicrobial resistance, the study said.
"WHO's hand hygiene improvement strategy is recommended by both the U.S. and European Centers for Disease Control, the Joint Commission International and accredited bodies, and almost all professional organizations worldwide," Didier Pittet, the study's senior author and director of the WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, said in a statement.
From December 2006 to December 2008, compliance with best practices increased from 51 percent before the study to 67 percent.
The findings were published in The Lancet Infectious Diseases.