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Published on: June 7, 2017
Patient Hand Hygiene Before Meals: A Systematic Review
Ariel Kamen1, Rebecca Clark, Michelle B Bass
1Author Affiliations: Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania (Miss Kamen and Dr Clark); Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, Pennsylvania (Miss Kamen, Drs Clark, Mull, and Mitchell); Pennsylvania Hospital, University of Pennsylvania Hospital System, Philadelphia, Pennsylvania (Drs Clark, Bass, Ms Fonshell); Division of Hospital Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Drs Holland and Mull); Penn Presbyterian Medical Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (Dr O'Donnell); Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Dr O'Donnell) .
Background:
Hand hygiene is recognized as an effective way to prevent health care-associated infections (HAIs). However, there is limited attention to patient hand hygiene (PHH).
Purpose:
The purpose of this systematic review was to summarize evidence, interventions, and outcomes of PHH before meals.
Methods:
Literature was searched from 1999 to 2024 in 4 databases. The Grading of Recommendations, Assessment, Development, and Evaluation was used to appraise the strength of evidence.
Results:
Ten reports were included in the review. Five categories of PHH interventions were identified: direct observation, reminders, education, policy change, and bundles of more than one intervention. There is insufficient evidence to establish a direct causal link between PHH before meals and a reduction in HAIs.
Conclusions:
The limited and moderate level of evidence highlights a significant gap in understanding PHH. Hand hygiene is a fundamental infection prevention strategy that warrants additional research in hospitalized patient populations to determine the clinical efficacy and causal effects on HAIs.
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