Patient Hand Hygiene Before Meals: A Systematic Review.

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.