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Is It Time for a Paradigm Shift in Hand Hygiene ?
By Kelly M . Pyrek
One of the widely recommended but deceptively difficult strategies for improvement is hand hygiene compliance . While it plays a significant role in breaking the chain of infection , hand hygiene is a venerated strategy that can sometimes be protected from scrutiny as to whether certain precepts still make sense for evolving real-world conditions and challenges in the healthcare environment .
Some clinical constructs have become so entrenched so as to be virtually unassailable , and a good example of this is the World Health Organization ( WHO )’ s Five Moments for Hand Hygiene , described by Gould and Purssell , et al . ( 2022 ) as a “ time-space framework to identify points in the sequence of care when hand hygiene should occur to prevent transmission .”
As we know , the Five Moments model conceptualizes risk in relation to two virtual areas : the patient zone – the patient and their immediate surroundings – and the healthcare zone , which comprises everything outside the patient zone .
Sax , et al . ( 2007 ) explain that “’ My five moments for hand hygiene ’ bridges the gap between scientific evidence and daily health practice and provides a solid basis to understand , teach , monitor and report hand hygiene practices .” The Five Moments are : Before touching a patient , before a clean / aseptic procedure , after body fluid exposure risk , after touching a patient , and after touching patient surroundings .
While it has become the most widely accepted framework since its formal launch in 2009 , not everyone was on board with this paradigm . For example , Chou , et al . ( 2012 ) analyzed the scientific foundation for the five moments of hand hygiene and explores the evidence , as referenced by WHO , to support these recommendations . They said they “ found no strong scientific
may 2024 • www . healthcarehygienemagazine . com •
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