Thousands of patients are being exposed to potentially fatal superbugs because their doctors and other hospital staff are not washing their hands, new data shows.
An audit of hand washing at 940 public and private hospitals in October found workers were not using alcohol-based hand rub on 16 per cent of the occasions they should be.
Doctors were one of the worst performing groups, along with cleaning and food staff and personal care attendants.
Of 7576 instances when doctors were meant to wash their hands before conducting a procedure, they did so on 6154 occasions or 81 per cent of the time.
They performed similarly after procedures. Despite being potentially exposed to body fluids, doctors washed their hands 80 per cent of the time, putting them at risk of carrying bacteria around the hospital. Their compliance rate taking in all types of occasion on which hands should be washed was 73 per cent.
The worst performing staff by area were in emergency departments.
The data from Hand Hygiene Australia, which is working to improve rates of hand washing among health workers, comes amid renewed fears about an emerging post-antibiotic era and calls for urgent action to prevent it.
In the Medical Journal of Australia, published on Monday, infectious disease experts said they were "deeply alarmed" by the recent death of an American woman due to a type of bacterium resistant to all classes of antibiotics.
Professor Cheryl Jones, president of the Australasian Society for Infectious Diseases, said the woman's death might herald a post-antibiotic era that would "profoundly affect all areas of healthcare, and society".
"Simple childhood infections would once again be life-threatening events, major surgery would be associated with high mortality, chemotherapy for cancer and organ transplantation would no longer be possible," Professor Jones and her colleagues wrote.
Professor Lindsay Grayson, an infectious disease specialist and director of Hand Hygiene Australia, said hand washing was an effective strategy to protect people from superbugs. He said it could save more than 1500 lives a year - more than Australia's road toll.
While annual data shows continuous improvement in hand washing among all health professionals, the October audit found some workers, wards and types of hospitals were worse than others.
Dentists and dental nurses performed the best, with overall hand washing rates of 93 per cent to 96 per cent. They were followed by nurses and midwives, with an overall rate of 87 per cent.
Invasive technicians, who assist with the insertion of medical devices, scored 84 per cent and allied health workers such as physiotherapists achieved 83 per cent.
Small public and private hospitals did better than their larger equivalents, and the wards with the highest rates of hand washing across all hospitals were those caring for babies, long-term patients and people with kidney disease.
The worst performing staff were in emergency departments, with an overall rate of 76 per cent. They were followed by general medical wards and critical care units with rates of 82-83 per cent.
Professor Grayson said the Hand Hygiene Australia program was the largest in the world, and although hand hygiene compliance rates were now better than in many similar countries such as the US and Britain, further improvement was needed.
Professor Jones and her colleagues said strategies to slow superbugs should be an urgent priority in Australia, which has the highest per capita consumption of antibiotics in the world.
"Australian prescribers and consumers need to reduce antibiotic use in humans and animals," they wrote.
They said more should be done to prevent the introduction of superbugs to Australia through people's international travel and ingestion of imported foods such as seafoods, which may have been produced with the use of antibiotics.
A summit on the topic will be held in Melbourne in June.
