Personnel within health care facilities have reportedly improved hand hygiene practices, according to a recent survey from World Health Organization (WHO). Dr. Benedetta Allegranzi, a scientist in WHO’s World Alliance for Patient Safety in Geneva, recently reported results from the WHO Hand Hygiene Self-Assessment Framework (HHSF), a snapshot of hand-hygiene practices and promotion worldwide.

The survey’s maximum possible overall score is 500 points. Based on its overall score, each health facility was assigned to one of four levels of progress: inadequate (0-125 points), basic (126-250 points), intermediate (251-375 points), or advanced (376-500 points).

Of the 9,032 health care facilities invited to participate, 2,119 facilities from 69 countries completed the survey. Nearly half of responding health care facilities (48 percent) delivered acute care and 48 percent delivered a mix of acute and long-term care. The overall score was a mean of 292.5 (intermediate level). Most facilities scored in the intermediate level (41 percent) or the advanced level (24 percent), Dr. Allegranzi said.

The researchers observed significant differences between regions, with the lowest overall score in Africa (mean, 218.5) and the highest in Western Pacific (mean, 351.8; P less than .001). The highest mean scores were observed in the HHSF sections regarding availability of facilities for hand hygiene (78.1), use of reminders (63.9) and staff education (61.4).

A majority of facilities (90 percent) reported having alcohol-based hand sanitizers available, 98 percent reported training staff on hand-hygiene best practices, and 92 percent reported displaying hand-hygiene posters in the wards (92 percent). However, "response to some specific questions indicate that substantial improvement is needed in the area of monitoring and feedback on hand-hygiene activities [a very important element of improvement strategies] and for the establishment of a comprehensive patient safety climate [well known to facilitate health care workers’ behavioral change]," Dr. Allegranzi said.

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