The National Health Service of Scotland comes down on the side of simple. It is poised to enact a new, no-tolerance policy: Wash your hands or lose your job.
It is important to add that the Scottish health service (a subset of the National Health Service of the entire UK) has actually done a good job of promoting hand hygiene in its hospitals. A year ago, an audit showed that Scottish hospitals were at 79% compliance, and so the service set a 12-month goal of 90% compliance.
(All of these numbers, by the way, are better than in the United States, where even intensive attention to hand-washing gets even caring hospitals only to about 70%. And yes, it is true that hand hygiene alone does not equal infection control — but it is the basic building block. If you can't establish hand hygiene, what are your odds of accomplishing more complex interventions?)
But now they've decided to go for 100%. In Scotland the move is being applauded. The Glasgow Evening Times editorialized:
If it takes the threat of the sack to make medical staff wash their hands then it is a justified action. It is scarcely credible that up to 10% of doctors, dentists and nurses do not practice this basic hygiene measure.Anyone want to disagree?