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Patients are more likely to see doctors and nurses with clean hands, putting them at lower risk of acquiring an infection, if they go to hospital in the morning, The Telegraph reported, citing a study.

Long days on the wards lead to medical staff increasingly neglecting to wash their hands towards the end of a shift, researchers discovered.

The demands of the job eroded the mental reserves that doctors and others dealing with patients needed to keep following the rules, they concluded.

Researchers looked at three years of hand-washing data involving 4,157 staff at 35 hospitals in the United States.

Protocols said that staff should wash their hands within a given time of going in and out of a patient’s room.

But the researchers found compliance dropped by an average of 8.7 percentage points between the beginning and end of a typical 12-hour shift. The effect was greater when staff were working harder.

It was enough to produce an extra 34 infections per 1,000 patients, a separate study cited by the researchers suggests.

“Just as the repeated exercise of muscles leads to physical fatigue, repeated use of executive resources (cognitive resources that allow people to control their behaviour, desires and emotions) produces a decline in an individual’s self-regulatory capacity,” the researchers wrote.

Staff tended to follow hand-washing rules more carefully after longer breaks during a shift, they discovered.

Hand-washing in hospitals has previously been demonstrated to reduce infections and save money.

In a Swiss study, researchers found that a 1 percentage point increase in hand-washing compliance reduced the number of infections by 3.9 per 1,000 patients.