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Alcohol-based hand rub consumption surveillance in German hospitals – latest results


HAND-KISS is a unit-based surveillance system of alcohol-based hand rub consumption (AHC). It is part of the German national nosocomial infection surveillance system (KISS).


We analyzed the development in AHC between 2007 to 2014.


Participating hospitals transfer data on patient days and AHC per unit once a year to HAND-KISS. The system calculates the data as AHC in milliliter (ml) per patient day (PD) stratified by unit type (intensive care units [ICU] and non-ICU) and specialty (medical, surgical, pediatrics, neonatal etc.). The distribution of all participating wards are published annually as HAND-KISS reference data.

To evaluate AHC changes over the years, we selected all hospitals and wards which continuously provided surveillance data over the whole period of 8 years. For all ICUs and non-ICUs we estimated the median AHC (interquartile range, IQR) for every year and compared the results.


188 hospitals with 334 ICUs and 1,954 non-ICUs transferred AHC data for 2007 (645 hospitals, 890 ICUs and 6,063 non-ICUs for 2014[g1]). 101 hospitals with 130 ICUs and 760 non-ICUs continuously provided surveillance data over a period of 8 years.

In 2007, the median AHC in the ICUs was 69 ml/PD (IQR, 52 ml/PD - 95 ml/PD), and in 2014 the result was 115 ml/PD (IQR, 84 ml/PD - 140 ml/PD) corresponding with an increase of 54%. The median AHC on non-ICUs was 15 ml/PD (IQR, 12 ml/PD - 18 ml/PD) in 2007 and 26 ml/PD (IQR 26 ml/PD - 32 ml/PD) in 2014 corresponding with an increase of 83%. The hospital-wide progression is 81%.


HAND-KISS is widely accepted in Germany. It is an established benchmarking tool to characterize hand hygiene behavior in an individual hospital.

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Behnke, M., Clausmeyer, J., Reichardt, C. et al. Alcohol-based hand rub consumption surveillance in German hospitals – latest results. Antimicrob Resist Infect Control 4 (Suppl 1), P293 (2015).

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