WHO Guidelines on Hand Hygiene in Health Care - Safe Care ...

<strong>WHO</strong> GUIDELINES ON HAND HYGIENE IN HEALTH CARE
9.
Towards a blueprint for developing,
implementing, and evaluating a national hand
hygiene improvement programme within
health care
Based on the current evidence and experience from existing national hand hygiene improvement programmes
(including national campaigns), this part concludes with an outline of the steps required in the development
of a national strategy for action on hand hygiene improvement. Central to the strategy is the process required
to progress from an initial desire to focus on hand hygiene improvement down to the actions required at a
local health-care facility level to implement the <strong>WHO</strong> multimodal strategy. The <strong>WHO</strong> Implementation Strategy
incorporates the evidence relating to implementation effectiveness within its core Guide to Implementation and
accompanying toolkit for improvement (http://www.who.int/gpsc/country_work/en/). Table IV.9.1 presents a
detailed framework for action, summarized in Figure IV.1.
10.
Conclusion
Avoidable harm continues to occur to patients receiving health care, because of the unreliable systems and
strategies that mitigate against optimal hand hygiene compliance. As part of the continued global effort to
ensure that no patient is unavoidably harmed through lack of compliance with hand hygiene, consideration
should be given to nationally-coordinated programmes (in some cases campaigns) to promote and sustain
hand hygiene improvement, keeping the issue in the national spotlight 1072 and ensuring effective implementation
of guidelines that have an impact on hand hygiene at the bedside. Noar 1066 emphasizes that even taking into
account the numerous caveats associated with campaigning, it is likely that targeted, well-executed mass media
health campaigns can have some effects on health knowledge, beliefs, attitudes, and behaviour. The existence
of guidelines does not in itself improve hand hygiene compliance. Therefore, the added impetus provided by
a nationally coordinated campaign or programme, with some form of monitoring and evaluation, targets and
regulation, has been demonstrated to provide a powerful adjunct to local implementation. In particular, to raise
awareness of the issue and elevate it to a level of prominence that might not be realized in the absence of a
nationally coordinated activity. For hand hygiene improvements to succeed within an integrated safety and
infection control agenda, national-level approaches should be considered.
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