Correspondence (letter to the editor): Video-based Approaches

Von Lengerke‘s working group studied compliance of hand hygiene measures in doctors and nursing staff. The data were collected by the use of questionnaires.

Response rates of 71% and 63% showed that tailored interventions helped improve compliance from 54% and 55% to 64% and 70%, respectively. The data obtained from the questionnaires were optimistically interpreted and the improvement rates were moderate. Professor Petra Gastmeier from Charité—Universitätsmedizin Berlin and coauthors estimated the number of hospital-acquired infections to be 500 000 and the number of deaths in Germany to be 15 000 (2).

Studies, using video monitoring, of hand hygiene measures showed that correct hygiene measures were only obeyed, at the start of the study, by 10–15%. By consistent video monitoring, after 12 weeks the compliance rose to 81% (3). Another study showed a rise of compliance from less than 10% to 82% after 16 weeks and after 75 weeks a rise to 88% (4).

Training and instructions are certainly tried and tested to show nursing staff and doctors the necessity of correct hand hygiene. But additionally, continuous monitoring—for example, by video—is the only proven measure to guarantee sustained good hand hygiene in hospitals. Insufficient hand hygiene should lead to a warning issued to prevent the maintaining of insufficient hand hygiene and such staff should be dismissed after the third such warning. Otherwise it is nearly impossible to improve the hygiene in Germanys‘ hospitals so that the number of cases of infection and deaths resulting from pathogens can be notably lowered.