Save lives: clean your hands

A call to action from Professor Didier Pittet, University Hospitals Geneva, Expert Lead for the WHO First Global Patient Safety Challenge.

“We must not forget that hand hygiene is a global issue. Patients are infected in healthcare environments everywhere”
-Didier Pittet

Healthcare-associated infection (HAI) occurs in every country and affects millions of patients annually worldwide. As a global issue, HAI has received much attention from healthcare settings and governments, as well as the public and media. The World Health Organization (WHO) made the commitment to address this problem through the successful activities of the First Global Patient Safety Challenge: 'Clean Care is Safer Care' launched in 2005.

Hand hygiene has been recognized as the single most important measure in these attempts and is the basis of actions promoted by ‘Clean Care is Safer Care’. As part of this challenge, over 120 ministries of health have pledged their commitment to tackle HAI. Healthcare facilities in many countries will be paying particular attention to taking action at the point of patient care on and around May 5, 2010, as participants in the WHO SAVE LIVES: Clean Your Hands initiative (the next phase of the First Global Patient Challenge dedicated to promoting hand hygiene sustainability).

More than 6000 healthcare settings from 126 countries have already registered for the SAVE LIVES: Clean Your Hands global annual initiative, representing over 2 million beds and 5 million healthcare workers.   

What can you do?
We ask you to support the call for action by: registering your facility to demonstrate a commitment to SAVE LIVES: Clean Your Hands and/or asking five others to do the same; sharing your plans and successes with others through local and national publications, as well as with WHO; finding out if there is an existing hand hygiene campaign in your country and seeing what you can do to support it; listing five areas for improvement in your facility and discussing these with your managers and staff; using and promoting a multimodal strategy to ensure sustained hand hygiene improvement,3,4,5 including the WHO’s ‘My 5 Moments for Hand Hygiene’ approach;6 and participating in the inaugural WHO infection control webinar series as an additional way to improve knowledge. During the week of May 3, 2010, five live webinars will take place, including one by me on May 5.

Where is your institution placed in the crusade for optimizing and sustaining hand hygiene performance and safe patient care? Assessing the level of your own institution, using a specifically designed approach, and working towards achieving the status of a hand hygiene excellence centre should be paramount. Using a framework to support such an approach will assess the level and improvements required, within a multimodal strategic context which has been tried and tested as part of "Clean Care is Safer Care". This multimodal strategy addresses: system change, healthcare workers’ education and training, monitoring and performance feedback, reminders in the workplace, and institutional safety climate.

To truly protect patients, it will take leadership, commitment, a range of actions, continuous assessment, experience-sharing, and time. Be part of a large cohort of observers and participate in monitoring of practices; we encourage healthcare institutions to consider this as part of their May 5, 2010 activities. The power of such an action can ultimately change behavior, improve care and reduce patient harm.

Have you considered what the patient safety/infection control research priorities are in your healthcare setting and have you considered publishing your work? WHO identified that studies addressing the cost effectiveness of patient safety activities are important in both developed5 and developing7 countries. In developed countries, studies on enhancing communications and safety culture were deemed priority areas.

The WHO Guidelines on Hand Hygiene in Healthcare3 clearly highlight where specific gaps still exist on this topic and welcome further studies and evidence of improving practices. The WHO First Patient Safety Challenge team is actively facilitating sharing of knowledge between nations/sub-nations running formal hand hygiene campaigns through a dedicated network of campaigning countries.

As lead for this exciting and powerful global movement, I firmly believe that we must not forget that hand hygiene is a global issue. Patients are infected in healthcare environments everywhere. It is our firm resolve to make hand hygiene improvement tools readily available so that healthcare workers regardless of their environment can access and utilize them.

Didier Pittet is Director of the Infection Control Program at University Hospitals Geneva and Expert Lead for the WHO First Global Patient Safety Challenge.

References:

1. Pittet D, Donaldson L. Clean Care is Safer Care: a worldwide priority. Lancet 2005;366:1246-1247.

2. Pittet D, Allegranzi B. Preventing infections acquired during healthcare delivery Lancet. 2008;372:1719-1720.

3. World Health Organization. WHO Guidelines for Hand Hygiene in Healthcare. Geneva: World Health Organization, 2009.

4. Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveaneau S, Perneger TV. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000; 356 :1307-1312.

5. Pittet D, Sax, Hugonnet S, Harbarth S. Cost implications of successful hand hygiene promotion. Inf Control Hosp Epidemiol 2004; 25: 264-266.

6. Sax H, Allegranzi B, Uckay I, Larson E, Boyce J, Pittet D. “My five moments for hand hygiene”: a user-centred design approach to understand, train, monitor and report hand hygiene. J Hosp Inf 2007; 67:9-21.

7. Allegranzi B, Sax H, Bengaly L, Richet H, Minta DK, Chraiti M-N, Sokonads M, Gayet-Ageron A, Bonnabry P, Pittet D, on behalf of the WHO Point G“ Project Management Committee. Successful implementatino of the World Health Organization hand hygiene improvement strategy in a referral hospital in Mali, Africa. Infect Control Hosp Epidemiol 2010; 31: 133-141.

---

This article was first published in EHM magazine: www.executivehm.com/article/Save-lives-clean-your-hands