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Involving patients, service users and visitors




Q. Surely encouraging patients to ask staff to clean their hands can’t be right? Patients will think we should already be doing it?

A. This is not what we found in the evaluation of the original pilot for the campaign in hospitals. Patients and service users can play a unique and important role as a partner in hand hygiene improvement. Patients were interested in being involved with hand hygiene improvement. Patients should be invited rather than obliged to ask staff about hand hygiene.



Q. Are visitors, patients/service users a big risk in spreading infection?

A: No. Promoting hand hygiene among visitors and patients/service users might be seen as a way of raising the profile of hygiene per se – but it is unlikely that this will impact on the rates of healthcare associated infection (HCAI). Healthcare staff – not visitors, patients or service users – are the ones with the greatest potential to transmit microorganisms. Increasing hand hygiene compliance amongst those staff remains the focus of the cleanyourhands campaign.


Whilst visitors to patients/service users come into contact with the general inpatient environment it is very rare that they have regular and prolonged contact with patients/service users. It is important to note how extremely unlikely it is that visitors will touch patients/service users in susceptible areas of the body – and even more so that they might need to move to touch other patients/service users and do the same. It is the hand hygiene of healthcare staff that we need to be monitoring and supporting – not visitors’ and patients/service users.


We do not wish to discourage patients/service users or visitors from observing good personal hygiene. Their awareness of the importance of hand hygiene in the drive to reduce HCAI is a key aspect of the cleanyourhands campaign. However, we must be clear about the critical role of visitors and patients/service users in supporting improvement:

  • to expect to see the correct behaviour on the part of healthcare staff;

  • to choose – if they wish – to support and work with organisations/staff to achieve excellence in enabling behaviour change through forums and other channels;

  • on the part of patient/ service user, or carers of children or patients/service users unable to communicate easily themselves: to minimise the risks of HCAI to themselves by asking about hand hygiene if or when the correct behaviour is not visible by staff.

We must promote and encourage patient/ service user involvement by making it clear to them that it’s OK to ask.