How to improve hand hygiene of cleaning staff

It is key that all staff in contact with patients or patient surroundings remember to perform hand hygiene. Even though cleaning staff are not involved in direct patient care, they often have contact with patient surroundings, such as the patient bed, which can lead to transfer of infectious organisms.

The hand hygiene of cleaning staff has only been investigated sparsely and these studies suggest that the compliance is lower compared with clinical staff (nurses, physicians etc.) and around 44%. An interesting study has recently been published, investigating attitudes towards hand hygiene amongst hospital cleaners. The study was conducted in a large hospital in Australia, using focus group discussions to elicit information from cleaning staff.

The study found that hospital cleaning staff are aware of the importance of hand hygiene and perceive it to be valuable activity. However, support from leadership and peers is perceived as important in order to chance behavior.

The study also found that cleaning staff do not consider audits to be a motivating factor for hand hygiene compliance. Instead, it has been found in other hospital workers that individual reward and recognition schemes are positive factors for hand hygiene performance and could be used to drive practice improvements. Especially awards to those excelling in hand hygiene is a strong motivator.

Interestingly, the cleaning staff viewed posters as ineffective barriers to hand hygiene because of inconsistency, information overload and poster blindness. They reported that they become inured to such visual reminders and do not have time to read them. Instead, they prefer customized education programs.

A key takeaway is that future hand hygiene campaigns need to avoid mixed messages and use simple, powerful wording. Even though it is a small study investigating the hand hygiene perception in a limited number of staff, it is clear that there is a need for more consistent and contextualized hand hygiene training to achieve improvements in practices among hospital cleaning staff.

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1.   Cleaning Staff’s Attitudes about Hand Hygiene in a Metropolitan Hospital in Australia: A Qualitative Study [Internet]. [cited 2019 Oct 23]. Available from:

2.   Harne-Britner S, Allen M, Fowler KA. Improving hand hygiene adherence among nursing staff. J Nurs Care Qual. 2011 Mar;26(1):39–48.

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