Hand hygiene in medicine and nursing through historical development, terminological analysis, and a public health perspective

Abstract

Hand hygiene represents one of the fundamental and most effective measures for preventing infections in medicine and nursing, and it is a key component of patient safety and the quality of healthcare. Despite its simplicity and long history of application, it is a complex phenomenon whose effectiveness depends on the interaction of scientific knowledge, organisational conditions, professional norms, and the social context. The aim of this paper is to analyse hand hygiene as a preventive measure in medicine and nursing through an interdisciplinary framework that integrates historical development, contemporary empirical evidence, and the public health thought of Andrija Štampar, professor and rector of the University of Zagreb. The purpose of the research is to understand hand hygiene not only as a clinical intervention, but also as a socially conditioned and systematically organised practice. The paper is based on a qualitative analysis of secondary sources, including scientific and professional literature, historical sources, and guidelines issued by international health organisations. The analysed literature encompasses works from interdisciplinary fields. The methodological approach includes the synthesis of theoretical models and a comparative historical and analytical interpretation. The results indicate that hand hygiene has undergone a transformation over time, from a general hygienic recommendation to a standardised, evidence-based medical practice. In modern healthcare systems, it is defined through precise guidelines and protocols; however, the level of compliance still depends on factors such as the education of healthcare professionals, organisational culture, resource availability, and risk perception. A particular contribution of this paper lies in linking contemporary knowledge with the principles of social medicine advocated by Štampar, which emphasise the importance of prevention, health education, and social responsibility. The paper confirms that the effective implementation of hand hygiene requires an integrated approach that goes beyond individual responsibility and includes institutional support, continuous education, and clearly defined public health strategies. Such an approach is essential for improving patient safety and ensuring the sustainability of healthcare systems.