What is Aktion Saubere Hände?

Aktion Saubere Hände has been in existence since 2008. It is a Germany-wide campaign to increase patient safety through improved implementation of hand hygiene in healthcare institutions.

How did the Action get its start?

Aktion Saubere Hände is based on the World Health Organization’s (WHO) campaign “Clean Care is Safer Care.” The improvement of patient safety is thus our primary goal. Hand hygiene is an effective measure to prevent the transmission of pathogens and the development of infections. Therefore, an improvement of hand hygiene by medical personnal represents a possible measure for increased patient safety.

Alcohol-based hand disinfectants have been used in Germany for a longer period of time than in other industrial nations. There is, nonetheless, uncertainty regarding the important and appropriate times for disinfecting hands. The campaign provides support for further education, information, and events and, in addition to disseminating knowledge, also offers materials, as motivation and reminders, for medical staff.


It is not easy to tell when measures for preventing infection have been well implemented by healthcare institution. One way of judging the quality of hygiene, for example, is to base it on one of our trusted criteria. We occasionally receive phone calls from patients and their families regarding hospital hygiene who tell us that a hallway does not appear to have been cleaned adequately. However, even if seems less than adequate from an aesthetic point of view, that does not necessarily reflect directly on actual hygiene in patient care.

Participants in Aktion Saubere Hände are able to receive certification and in this way communicate their efforts to the public. In particular, hospitals with a silver or gold certificate have invested a great deal of work and resources in improving hand hygiene.

A complete list of participating institutions and their level of certification can be found at Participating Institutions

There are several measures that scientific studies have shown to have significant results when implemented.

The package of measures includes the following components:

  1. Participation in a one-day introductory course
  2. Improvement in the provision of the hospital with hand disinfectant dispensers to ensure they are immediately accessible and near at hand for hospital staff.
  3. Teaching and implementation of the WHO program “My Five Moments for Hand Hygiene” as an educational tool which will make the confident recognition of the indications for hand hygiene easier for staff during their fast-paced, complex work day.
  4. The use of measurement instruments for evaluation of and feedback concerning hand hygiene behavior (determination of the consumption of hand disinfectant and monitoring of staff during their work with patients).
  5. Holding regular training sessions on hand hygiene and infection prevention.
  6. The distribution of promotional materials and reminders.
  7. Holding special “Hand Hygiene Days”
  8. Participation in the annual exchange of experience

Most patients are not only treated or otherwise cared for in hospitals, but also as outpatients or in nursing homes. Treatment-associated infections and multi-resistance by pathogens to antibiotics present a great challenge to all sectors of healthcare, not only hospitals. Invasive therapies and diagnostic procedures are performed more and more in outpatient settings. For this reason it is of great importance to involve these areas in the program.

Almost 1000 hospitals, 150 nursing homes, and 500 outpatient facilities in Germany and Austria are participating in Aktion Saubere Hände(July 2022)

A study in hospitals which have been tracking consumption of hand disinfectant since 2007 has shown that up to 2019 the consumption of hand disinfectant on intensive care units as well as in normal wards has doubled.


The development of healthcare-associated infections has a variety of causes. Only some of these infections can be prevented. As a rule, infections are prevented by taking several measures at the same time. Hand hygiene is a fundamental component but not the only one by far.

In the meantime, Aktion Saubere Hände has established WHO’s program Germany along with a national system for the long-term tracking of the consumption of hand disinfectant (HAND-KISS). The calculation of reference data has made it possible for similar institutions to compare results.

Aktion Saubere Hände has established a standardized method of monitoring (compliance monitoring) in Germany as an evaluation instrument. We consider our greatest success to be the increased number of institutions which have voluntarily implemented monitoring in their practices and wards. It is only by means of monitoring that it is possible to give staff immediate and focused feedback for improvement. It is good to see that a greater awareness of patient safety has also arisen from the discussion of hand hygiene.

The provision of disinfectant dispensers has increased significantly. The dispensers are used considerably more often. This is also evident from the consumption of hand disinfectant which has doubled in hospitals - in intensive units as well as normal wards - that participated continuously during the years 2008-2019.

The success of the campaign in an individual institution depends in large part on the measures taken as well as from the support of management. Successful implementation ties up staff resources.

We need new strategies in order to achieve to further improvement in hospitals. In this regard, focused, timely feedback of results along with training in specific areas are of central importance. The precise analysis of future work routines and the creation of a structure that leads to fewer moments for hand hygiene and thus to less burden on individual employees. In addition, it will be productive to have precise descriptions of processes in order to avoid unnecessary hand hygiene.

We also see further potential for improvement in the areas of long-term and outpatient care. Even when the risks of infection are not considered as serious, the same high standards of patient protection apply as in hospitals.

Aktion Saubere Hände awards a certificate to hospitals, rehabilitation clinics and outpatient facilities.

The criteria are different for each facility. The campaign awards a bronze, silver and gold certificate to a hospital or rehabilitation clinic. The criteria provide a good overview of the efforts that a rehabilitation clinic or hospital makes to maintain or continuously improve their standards of hygienic hand disinfection.

Outpatient facilities only receive a certificate of participation.

Explanations of the certificate for outpatient facilities

Explanations of the certificate for hospitals