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American Journal of Infection Control
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Major article| Volume 42, ISSUE 3, P224-230, March 2014

Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities

DOI:https://doi.org/10.1016/j.ajic.2013.11.015
Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities
Previous ArticleAcknowledgment of Reviewers
Next ArticleMedical students' perceptions of their role as covert observers of hand hygiene

      Background

      The World Health Organization (WHO) launched a multimodal strategy and campaign in 2009 to improve hand hygiene practices worldwide. Our objective was to evaluate the implementation of the strategy in United States health care facilities.

      Methods

      From July through December 2011, US facilities participating in the WHO global campaign were invited to complete the Hand Hygiene Self-Assessment Framework online, a validated tool based on the WHO multimodal strategy.

      Results

      Of 2,238 invited facilities, 168 participated in the survey (7.5%). A detailed analysis of 129, mainly nonteaching public facilities (80.6%), showed that most had an advanced or intermediate level of hand hygiene implementation progress (48.9% and 45.0%, respectively). The total Hand Hygiene Self-Assessment Framework score was 36 points higher for facilities with staffing levels of infection preventionists > 0.75/100 beds than for those with lower ratios (P = .01) and 41 points higher for facilities participating in hand hygiene campaigns (P = .002).

      Conclusion

      Despite the low response rate, the survey results are unique and allow interesting reflections. Whereas the level of progress of most participating facilities was encouraging, this may reflect reporting bias, ie, better hospitals more likely to report. However, even in respondents, further improvement can be achieved, in particular by embedding hand hygiene in a stronger institutional safety climate and optimizing staffing levels dedicated to infection prevention. These results should encourage the launch of a coordinated national campaign and higher participation in the WHO global campaign.

      Key Words

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      Article info

      Footnotes

      B. Allegranzi and L. Conway contributed equally to this article.

      Conflicts of interest: None to report.

      Identification

      DOI: https://doi.org/10.1016/j.ajic.2013.11.015

      Copyright

      © 2014 World Health Organization. Published by Elsevier Inc. All rights reserved.

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