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National Patient Safety Agency

Healthcare staff told: Clean your hands at the point of care to save lives

2 September 2008


Today (2 September) the National Patient Safety Agency (NPSA) has reissued its Alert on hand hygiene to reinforce its importance as a significant factor in reducing infection in health.


The guidance has been produced by the NPSA and applies to all NHS staff in England and Wales who have direct contact with patients.


Speaking of the “Clean Hands Save Lives” alert, Martin Fletcher, Chief Executive of the NPSA said:


“The patient safety alert highlights the need for all healthcare staff to clean their hands at the point of care – that is, the patient’s immediate environment where treatment takes place – as this is when there is the greatest risk of transferring infection. In hospitals, the point of care will usually be around the patient’s bed, while in other settings this could be a treatment room, cot, chair, ambulance or the patient’s home.”


The NPSA recommends the use of alcohol handrub only on non-soiled hands as it is effective and quick to use. If hands are visibly dirty or if the patient has been experiencing vomiting or diarrhoea then the healthcare staff must wash their hands with liquid soap and water.


From 1 November 2003 to 15 July 2008 there have been 379 patient safety incidents reported to the NPSA involving alcohol handrub. Although the majority of these resulted in no or low harm the NPSA believes that these risks could be managed if NHS trusts followed their recommendations on where the handrub dispensers should be placed.


“The National Patient Safety Agency has always said that alcohol handrub is most effective when the dispensers are installed at the point of care as this is when staff should be cleaning their hands to avoid spreading infection,” Martin Fletcher said. “In most cases this is at the foot of the patient’s bed, their bedside locker or their chair. We recommend staff use personal dispensers, particularly if they treat children or mental health patients, as this further minimises risk. Hospitals that install handrub dispensers away from the point of care, including along corridors or at ward entrances, must take the necessary safety and storage precautions”.


To coincide with the alert, which replaces guidance from 2004 and now includes best practice guidelines set by the World Health Organisation (WHO), the NPSA is hosting a summit today (2 September) at the UCL Institute of Child Health. The summit will highlight issues such as risk management and the international standard for hand hygiene products through a series of presentations by the WHO World Alliance for Patient Safety, Health Protection Agency, Department of Health and Welsh Assembly Government.


Local organisations remain responsible for making sure their healthcare staff comply with hand hygiene procedures, and the NPSA will review how the alert has been put into practice in April 2009.


View the patient safety alert “Clean Hands Save Lives”.




Notes for editors:


  1. Media enquiries to Paul Cooney in the NPSA Communications Department on 020 7927 9351 / paul.cooney@npsa.nhs.uk or Amelia Lyons on 020 7927 9580 / amelia.lyons@npsa.nhs.uk.
  2. The Summit, entitled “All Hands to the Pump: Improving the culture of hand hygiene in the NHS”, will be held at the UCL Institute of Child Health on Tuesday 2 September. There is limited capacity for media attendance. If you are a journalist and would like to attend, contact Paul Cooney on 020 7927 9351.
  3. The patient safety alert “Clean Hands Save Lives” is based on the first hand hygiene alert issued by the NPSA in September 2004 and is revised in line with the current best practice guidelines for 2008. It is the first in the “Worth Repeating” series which the NPSA has introduced to raise awareness of important patient safety issues.
  4. From 1 November to 15 July 2008, the NPSA’s National Reporting and Learning System (NRLS) received 379 reports of patient safety incidents involving alcohol handrub in NHS trusts in England and Wales. Of these the majority were reported as low or no harm. The NRLS is designed for confidential reporting of patient safety errors and systems failures by health professionals across England and Wales. The confidential data is analysed by the NPSA to identify national patient safety trends and priorities, and to develop practical solutions. The aim is to help the NHS to learn from things that go wrong.
  5. In July 2008 the cleanyourhands campaign released a guidance DVD to all NHS trusts in England and Wales, demonstrating the correct procedures for hand hygiene.
  6. The NPSA-run cleanyourhands campaign aims to improve the hand hygiene of healthcare workers and helps the NHS tackle healthcare associated infections. Since its launch in 2004, the campaign has been adopted by all NHS acute trusts in England and Wales, and has more than doubled the rate of hand hygiene. In July the campaign was extended to primary care, mental health, ambulance and care trusts.
  7. The National Patient Safety Agency encompasses the National Research Ethics Service, National Reporting and Learning Service and the National Clinical Assessment Service. Our vision is to lead and contribute to improved, safe patient care by informing, supporting and influencing healthcare individuals and organisations. Each division works within its sphere of expertise to improve patient outcomes.