Monitoring hand hygiene adherence and providing performance feedback to health care
workers is a critical component of multimodal hand hygiene promotion programs, but
important variations exist in the way adherence is measured. Within the framework
of the World Health Organization's (WHO) First Global Patient Safety Challenge known
as “Clean Care is Safer Care,” an evidence-based, user-centered concept, “My five
moments for hand hygiene,” has been developed for measuring, teaching, and reporting
hand hygiene adherence. This concept is an integral part of the WHO's hand hygiene
improvement strategy conceived to translate the WHO Guidelines on Hand Hygiene in
Health Care into practice. It has been tested in numerous health care facilities worldwide
to ensure its applicability and adaptability to all settings irrespective of the resources
available. Here we describe the WHO hand hygiene observation method in detail—the
concept, the profile and the task of the observers, their training and validation,
the data collection form, the scope, the selection of the observed staff, and the
observation sessions—with the objective of making it accessible for universal use.
Sample size estimates, survey analysis and report, and major bias and confounding
factors associated with observation are discussed.
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Article Info
Footnotes
The World Health Organization takes no responsibility for the information provided or the views expressed in this article. The authors report no conflicts of interest.
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© 2009 World Health Organization 2009. Published by Elsevier Inc. All rights reserved.
