About hand hygiene

Poor hand hygiene compliance among healthcare workers is strongly associated with healthcare associated infection (HAI) transmission and is a major factor in the spread of antibiotic-resistant organisms within hospitals. Improving hand hygiene among healthcare workers in acute care settings has been prioritised by the Australian Commission on Safety and Quality in Health Care (ACSQHC) With the development of the National Hand Hygiene Initiative (NHHI).

Read more about the initiative and find NHHI’s resources:

Improving hand hygiene compliance in healthcare workers is reliant on a number of factors including, human behaviour, organisational culture and leadership. A multifaceted approach is required in order to achieve improved hand hygiene compliance.

Risks associated with poor hand hygiene

Healthcare associated infections (HAIs) pose a serious threat to people admitted to hospital and contribute to the economic burden of healthcare.

  • Micro-organisms are readily transmitted on health care workers' hands
  • It is estimated that there are around 200,000 HAIs in Australian hospitals each year.
  • It is possible to reduce HAIs by using effective infection prevention practices, such as improving hand hygiene compliance.
  • Research has shown that improving hand hygiene compliance is about human behaviour, organisational culture and leadership and requires a multifaceted approach to achieve improved hand hygiene compliance.

Hand Hygiene Compliance

There are many reasons for sub-optimal hand hygiene compliance among healthcare workers, including:

  • Environment - location and/or availability of hand washing sinks
  • Organisational - availability of high profile clinical role models
  • Psychological - a perceived lack of time for hand hygiene
  • Education - for example, misconceptions about when hand hygiene should be performed
  • Physical factors - for example skin irritation and dryness

Research has shown that behavioural change requires a multi-level, multidisciplinary, multi-modal program. Hand hygiene compliance programs should consider:

  • Education programs
  • Feedback and positive reinforcement
  • Administrative mandate (and sometimes organisational culture and system change)
  • Leadership and motivation

The National Hand Hygiene Initiative (NHHI) provides resources and guidance for all Australian healthcare facilities.

Mass Gathering Hand Hygiene Guideline (PDF 107 kB)

Last updated: 8 September 2025