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

<strong>WHO</strong> GUIDELINES ON HAND HYGIENE IN HEALTH CARE
1.
Overview and terminology
Patient empowerment is a new concept in health care and has now been expanded to the domain of patient
safety. In developing countries, this has been influenced significantly by the USA IHI reports on health quality and
safety, with a focus on increasing the public’s awareness of medical errors and national efforts to actively engage
patients in their care. 1041,1099 Even though the term can have different meanings and interpretations, empowerment
in health care generally refers to the process that allows an individual or a community to gain the knowledge,
skills, and attitude needed to make choices about their care. The term patient participation is more often used
when referring to chronic diseases such as diabetes, in which patients are invited to participate in the ongoing
decisions of their care. Patient empowerment is generally required in order for patients to participate. Thus
empowerment refers to a process that, ultimately, leads patients to participate in their care.
Although there are many unanswered questions about how
to approach patient involvement, this part of the guidelines
presents the evidence supporting the use of programmes
aiming to encourage patients to take a more active role in their
care, especially with regard to hand hygiene promotion, using a
three-fold approach:
• review the current literature on patient and HCW
empowerment and hand hygiene improvement;
• report on the results of the <strong>WHO</strong> Global Patient Survey of
patients’ perspectives regarding their role in hand hygiene
improvement;
• propose a multifaceted strategy for empowerment that can
be incorporated into a broader, multimodal, hand hygiene
improvement strategy.
2.
Patient empowerment and health care
The term chosen to engage and involve patients will depend on what is appropriate for the specific culture of
a region or community. Patient empowerment might be the preferred term from a patient advocacy point of
view. However, the less emotionally charged and challenging term patient participation might be a term more
acceptable to many HCWs, patients, and cultures. For the purpose of these guidelines, the word empowerment
is used.
<strong>WHO</strong> defines empowerment as “a process through which
people gain greater control over decisions and actions affecting
their health” and should be seen as both an individual and a
community process. 1100
A process in which patients understand their role, are given the
knowledge and skills by their health-care provider to perform a
task in an environment that recognizes community and cultural
differences and encourages patient participation.
Four components have been reported as being fundamental
to the process of patient empowerment: 1) understanding
by the patient of his/her role; 2) aquisition by patients of
sufficient knowledge to be able to engage with their healthcare
provider; 3) patient skills; and 4) the presence of a
facilitating environment. 1101 Based on these four components,
empowerment can be defined as:
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