IMPROVING HAND HYGIENE IN CRUISE SHIP: AN INTERVENTION STUDY

Surface disinfection, technique monitoring, and passenger training did not improve hand hygiene in the forms applied in this study. Crew training improved theoretical knowledge, but we were not able to demonstrate any measurable behavioural change. There were some additional lessons from the study. Hand hygiene compliance is primarily determined by the setting-the placement of dispensers and whether passengers are reminded to use them. Language barriers are a limiting factor that should be considered when planning communication strategies for both crew and passengers. On cruise ships, hand hygiene is often associated with food hygiene. While there are clear recommendations in that area, there is a lack of guidelines on how to improve passengers' hand hygiene. Some passengers have strong opinions about hand hygiene-either positive or negative-but they are a minority. The majority of passengers are not interested on hand hygiene; they perform it when the setting is optimal but otherwise skip it. Clear recommendations are needed to establish an environment that effectively promotes hand hygiene.