UCL Antimicrobial Resistance


The National Clean Your Hands Campaign

A multidisciplinary team lead by UCL evaluated the first national hand hygiene campaign in the world, upon which the WHO’s current multimodal hand-hygiene intervention is now based. The campaign comprised provision of alcohol hand rub at the bedside, distribution of posters reminding healthcare workers to clean their hands, regular audit and feedback of compliance, and provision of materials empowering patients to remind healthcare workers to clean their hands. Questionnaires were distributed to acute trusts asking them to report implementation of each component. Data was collected from each trust on routine surveillance data, procurement of alcohol handrub and soap, other infection control interventions and potential confounders.

The results showed widespread implementation of all components except for patient empowerment, sustained throughout the four years of the study (ref 1).

Combined procurement of soap and alcohol hand rub tripled, rising in association with each phase of the campaign. Rates of MRSA bacteraemia and C difficile infection fell. There were strong independent associations of increased soap procurement with reduced C difficile infection, and of increased alcohol hand procurement with reduced MRSA bacteraemia. These strong independent associations remained, even after adjustment for all other interventions (publication of the Health Act, Department of Health improvement team visits) associated with reductions in infection.

The study suggests that national infection control interventions, including a hand hygiene campaign, undertaken in the context of a high profile political drive, can successfully change many aspects of hand-hygiene behaviour and reduce selected healthcare associated infections (Ref 2). 


1. Fuller S, Savage J, Cookson BS, Hayward A, Cooper B, Duckworth G, Michie S, Jeanes A, Teare L, Charlett A, Stone SP. National observational study to evaluate the “cleanyourhands” campaign (NOSEC): a questionnaire based study of national implementation. Antimicrobial Resistance and Infection Control 2015; 4:52 https://doi.org/10.1186/s13756-015-0077-0

2. Stone SP,  Fuller S, Savage J, Cookson BS, Hayward A, Cooper B, Duckworth G, Michie S, Murray M, Jeanes A, Roberts J,  Teare L, Charlett A.  Evaluation of the national Cleanyourhands campaign to reduce Staphylococcus aureus bacteraemia and Clostridium difficile infection in hospitals in England and Wales by improved hand hygiene: four year, prospective, ecological, interrupted time series study.: BMJ 344:e3005doi: https://doi.org/10.1136/bmj.e3005