UNICEF/UNI117109/Pirozzi
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The problem
Available evidence shows that compliance with hand hygiene recommendations during health care delivery remains suboptimal around the world, with an average of 59.6% compliance levels in intensive care units up to 2018, and extreme differences between high income and low income countries (64.5% vs 9.1%).
Out of every 100 patients in acute-care hospitals, seven patients in high-income countries (HICs) and 15 patients in low- and middle-income countries (LMICs) will acquire at least onehealth care-associated infection during their hospital stay.
Most health-care facilities have an intermediate level of hand hygiene implementation or higher, for which health care facility funding and country income level are important drivers.
WHO / Hugh Kinsella Cunningham
Handwashing and hygiene procedures at Kitatumba Hospital, Butembo. This hospital is receiving support from the WHO.
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The solution
Most HAIs are preventable through hand hygiene performed at the right times.
The WHO Guidelines on hand hygiene in health care outline hand hygiene recommendations and are complemented by the WHO Multimodal hand hygiene improvement strategy, the Guide to implementation, and an implementationtoolkit, which contains many ready-to-use practical tools.
The WHO multimodal improvement strategy has been shown as the most effective approach leading to practices improvements. Hand hygiene improvement programmes can prevent up to 50% avoidable infections acquired during health care delivery and generate economic savings on average 16 times the cost of implementation.
Evidence
23 May 2022
Global report on infection prevention and control
5 May 2017
Evidence of hand hygiene as the building block for infection prevention and control
14 July 2016
Summary report: hand hygiene self-assessment framework survey 2015/2016
Additional literature
- A literature review of MDROs and the relationship with hand hygiene – summary pdf, 316kb
- A report on the June 2015-January 2016 WHO global Hand Hygiene Self-Assessment Framework survey
- Moment 1 Global Observation Survey pdf, 88kb
- Systematic review of automated electronic systems for hand hygiene monitoring (preliminary results)pdf, 168kb
- WHO Hand Hygiene Self-Assessment Framework Global Survey Report 2011, pdf, 413kb
- Evidence of hand hygiene to reduce transmission and infections by multidrug resistant organisms in health-care settings
- Interim results on the WHO global surveys on MDROs and surgical antibiotic prophylaxis in health care
Key publications on hand hygiene
Hand hygiene is vital for safe health care delivery, yet practices at the point of care remainsuboptimal worldwide. A comprehensive research agenda...
5 May 2021
Resource considerations for investing in hand hygiene improvement in health care facilities
Investment in all the drivers and facilitators of hand hygiene action in health care to ensure thatit occurs at the point of care and other critical...
12 October 2020
Hand hygiene for all initiative: improving access and behaviour in health care facilities
The WHO and UNICEF-led Hand Hygiene for All Initiative aims at ensuring implementation for WHO's global recommendations on hand hygiene to prevent and...
The scope of this document is to address practical aspects related to the performance of routine hand hygiene while providing outpatient care. This document...
9 February 2009
A guide to the implementation of the WHO multimodal hand hygiene improvement strategy
WHO_IER_PSP_2009.02_chi.pdf (5.297Mb)WHO_IER_PSP_2009.02_per.pdf (1.857Mb)
15 January 2009
WHO guidelines on hand hygiene in health care
The WHO Guidelines on Hand Hygiene in Health Care provide health-care workers (HCWs), hospitaladministrators and health authorities with a thorough...
Implementation
To succeed in IPC and bring about safer, high quality health care practices, implementation and improvement at the point of care is critical.The tools and resources here are associated with elements of the multimodal improvement strategy, including how to achieve system change, building the right environment to make hand hygiene possible at the point of care, reminders and communications and a safety culture.
Training
The tools and resources here are associated with the training and education element of the multimodal improvement strategy. All health workers require clear and comprehensive training and education to ensure hand hygiene action is aligned with evidence and local policies and is highlighted as a life-saving action if performed at the right times.
Monitoring
The tools and resources here are associated with the monitoring and feedback element of the multimodal improvement strategy. Evaluation of hand hygiene practices and related perception and knowledge supports hand hygiene improvement over time.
Campaigns and initiatives
WHO issues many additional documents onhandhygiene in health care every year on 5 May, WorldHandHygieneDay; these can be found in the campaign specific pages.
