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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 August 4; 335(7613): 221.
PMCID: PMC1939751
Hand hygiene and the CMO

What about reducing turnover?

Nigel G B Richardson, consultant surgeon

The chief medical officer (CMO) states that hand washing is a major priority and quotes examples of poor practice by doctors and nurses.1 Like so many before him, he makes no mention of overuse of NHS facilities as being a critical factor in the battle against hospital infections because (presumably) it is so politically uncomfortable to do so.

Of course hand washing could be improved—but so could ward occupancy rates approaching 100% in acute wards. I suspect that we will never get significantly reduced rates of hospital acquired infection until we accept that wards must slow down their turnover, a solution which local managers cannot consider owing to intolerable pressure “from above” to improve so called efficiency.


Competing interests: None declared.


1. Day M. Chief medical officer names hand hygiene and organ donation as public health priorities. BMJ 2007;335:113 (21 July.)

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