Scenario-based simulation training for the WHO hand hygiene self-assessment framework

Abstract Background:A World Health Organization (WHO) guideline-based multimodal hand hygiene (HH) initiative consisting of the 5 Components, the 5 Steps, and the HH Self-Assessment Framework (HHSAF) was introduced hospital-wide to a nonteaching Japanese hospital for 5 years. The objective of this study was to assess the effect of this initiative in terms of changes in alcohol-based hand rub (ABHR) consumption and HHSAF score.Methods:The consumption of monthly hospital-wide ABHR was calculated as ml per patient day (PD). The change in ABHR consumption was analysed by an interrupted time series analysis, with a preintervention period of 36 months and an intervention period of 60 months. The correlation between annual ABHR consumption and the HHSAF score was estimated using Pearson’s correlation coefficients.Results:A statistically significant increase was found in the monthly ABHR consumption (change in slope: + 0.479 ml/PD, p < 0.01). Annual ABHR consumption was strongly correlated with the annual HHSAF score (r = 0.971, p < 0.01).Conclusions:A 5-year, 5-step, WHO-based HH initiative significantly increased ABHR consumption. Our study suggested that the HHSAF score can be a good process measure to improve HH in a single facility, as ABHR consumption increased with the HHSAF score.

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Hand hygiene: are WHO Framework scores consistent with hand rub consumption data? A regional study

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.695 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

J Garlasco ◽

C Vicentini ◽

I N Emelurumonye ◽

F Quattrocolo ◽

G D'Alessandro ◽

...

Keyword(s):

Hand Hygiene ◽

Hand Hygiene Compliance ◽

Performance Indicator ◽

Statistical Significance ◽

Good Practice ◽

Local Health ◽

Assessment Framework ◽

Self Assessment ◽

Hospital Unit ◽

Hygiene Compliance

Abstract Background Hand hygiene represents one of the most effective measures to prevent infection transmission in healthcare facilities and may reduce healthcare-associated infections by up to 15-30%. In Piedmont (a region in North-West Italy), hand hygiene compliance is routinely monitored through the WHO Hand Hygiene Self-Assessment Framework (HHSAF) and each hospital is also required to provide data about alcohol-based hand rub (ABHR) consumption as part of the regional performance indicator surveillance system. The aim of this study is to assess whether these two systems yield consistent results, i.e. whether numerical data matches the self-reported status of hand hygiene compliance. Methods For the years 2015-2018, data on ABHR consumption (in millilitres per patient-day, ml/PD) were collected annually at a facility level (40 hospitals) and then aggregated according to the corresponding local health unit/hospital unit, whereas the HHSAF scores were collected at a health/hospital unit level (18 units). The analysis was performed through logistic regression, by taking the WHO HHSAF score (continuous variable) as predictor and ABHR consumption as response variable, dichotomously considered as “low” or “high” (respectively below or above the 20 ml/PD threshold commonly accepted for good practice in hand hygiene). Results This study found that a high level of ABHR consumption is more likely to be observed in hospitals/health units with higher HHSAF scores, with a 1.14-fold increase in the odds for every 10-point increase in the HHSAF score. Despite the limited number of observations due to data aggregation, the result reached borderline statistical significance (p = 0.05). Conclusions The ABHR consumption surveillance provides feedback heading in the same direction as the results of the HHSAF, therefore the two surveillance systems are consistent. These findings provide further support for the validity of the HHSAF score as a reasonable predictor of hand hygiene compliance. Key messages The WHO Hand Hygiene Self-Assessment Framework score is a reliable predictor of hand hygiene compliance, as a high hand rub consumption is more likely to occur in hospitals with higher HHSAF score. Surveillance through the WHO HHSAF should be encouraged, along with alcohol-based hand rub (ABHR) measurement, and these results should be used to guide action plans to promote hand hygiene.

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A Journey of Hand Hygiene (HH) from Basic to Advance Level at a Tertiary-Care Hospital in Karachi, Pakistan

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.594 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s95-s95

Author(s):

Rozina Roshanali

Keyword(s):

Hand Hygiene ◽

Role Models ◽

Healthcare Workers ◽

Safety Climate ◽

Action Plan ◽

System Change ◽

Assessment Framework ◽

Self Assessment ◽

Training And Education ◽

Healthcare Facilities

Background: According to the WHO, hand hygiene is the primary measure to reduce infections. It is a simple act, but the lack of compliance among healthcare workers has been a great concern for all healthcare facilities. Healthcare facilities can perform a situation analysis of hand hygiene promotion and practices according to a set of indicators designed by the WHO in the form of a hand hygiene self-assessment framework. Results can be used to identify areas of improvement and to develop an action plan and strategies accordingly. Low- or middle-income country (LMIC) initial scoring within this framework was 195 points (ie basic level); thus, we aimed to achieve the advanced level, with a score of > 375. Methods: The WHO hand hygiene self-assessment framework is a diagnostic tool to identify key issues requiring attention and improvement. Repeated assessments are done to document the progress over time, which allows a health-care facility to track their progress in hand hygiene resources, to conduct promotion activities, to plan their actions, and to achieve improvement and sustainability. We developed an action plan under each category of WHO framework that included: system change, training and education, evaluation and feedback, reminders in workplace, and institutional safety climate for hand hygiene. We implemented the following measures: point-of-care hand hygiene stations were made available at all bedsides; mandatory training was introduced for all healthcare workers, and consumption of hand rub or hand sanitizers and liquid soap was monitored as a consumption indicator. In addition, posters were placed in all wards and clinics, time was dedicated for HH promotion, and a May 5th plan was implemented. HH leaders, role models, and champions were identified from each discipline. Patients were involved in HH promotion; HH leaflets were given to patients, HH e-learning tools were implemented, and a system for personal accountability was initiated, as well as a buddy system for new employees. Results: After implementation of multiple strategies in each section of the WHO self-assessment framework, we our overall score increased from basic (ie, 195) to advanced (ie, 395). In addition, category score increased in system change from 60 to 85, in training and education from 35 to 100, in evaluation and feedback from 52.5 to 100, in reminders in workplace from 17.5 to 45, and in institutional safety climate from 30 to 65. Conclusions: The WHO hand hygiene self-assessment framework should be utilized by all the hospitals in LMICs as a guide to improve hand hygiene levels.Funding: NoneDisclosures: None

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