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

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<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. 182
PART IV. TOWARDS A GENERAL MODEL OF CAMPAIGNING FOR BETTER HAND HYGIENE – A NATIONAL APPROACH TO HAND HYGIENE IMPROVEMENT Table IV.8.1 The public information component of two national campaigns focusing on the prevention of health care-associated infection Campaign Interventions and tools Target audiences Implementing bodies Significant results “cleanyourhands” England and Wales 1029 (September 2004 to date) A multimodal campaign based on social marketing and sustainable methodology aimed at educating and providing prompts. It includes: Implementation guide with supporting resources for HCWs with ongoing support through e-bulletins and local visits A series of three posters: the core campaign posters; the staff champion posters; the patient posters HCWs Senior management within health-care settings Patients Hospital visitors Partner organizations NPSA NHS Trusts Department of Health Welsh Assembly Government 100% of all acute trusts in England and Wales signed up to the campaign 80% of trusts say hand hygiene is a top priority Use of alcohol handrub and soap has risen threefold Initiated patient empowerment pilot Expanded programme to non-acute sector Patient leaflets, badges, stickers to encourage patient involvement Printed information materials including staff leaflet, multi-purpose panels and pump indicators A media kit A campaign web site Screen saver Media launches of the campaign involving local celebrities Conferences National televised debate 183
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