Patient safety

Clean Care is Safer Care

Indicators for a WHO global annual campaign - demonstrating commitment and action!

The WHO Clean Care is Safer Care programme is again promoting its global annual campaign, WHO SAVE LIVES: Clean Your Hands. The campaign was launched in 2009 and aims to 'bring people together to improve and sustain hand hygiene every 5 May' in order to maintain a global profile on the importance of this action to reduce health care-associated infections. Wide global engagement has been critical in these early years and tracking a number of indicators has allowed WHO to understand the impact thus far.

Health-care facility registrations indicator

The campaign started with the target of gathering health-care facility registrations in order to show their engagement to hand hygiene improvement and to be part of the global campaign. In its first two years on each 5 May, unprecedented commitment was reached through registrations from 5 000 health-care facilities in 2009, and a cumulative total of over 11 000 in 2010, well exceeding the 10 000 target. No specific further target was set for 2011 but rather the aim of reaching countries or Regions that still have low numbers of registered facilities. The numbers continue to gently increase and these are constantly presented by WHO region and country on our web pages:

Key organisations commitment indicator

Since its launch in 2004, WHO Patient Safety's patient engagement initiative, Patients for Patient Safety (PFPS) has worked to strengthen the voice of patients as advocates for safer health care, primarily through the network of patient champions around the world. Last year, PFPS carried out an evaluation to assess, for the first time, the impact and effectiveness of the project. Although examples of the activity, influence and impact of many individual champions was known, this had never been recorded and analysed in a systematic and objective way.

The commitment from key organisations eager to support WHO has also been evident. A number of these have promoted registrations and calls for action by WHO SAVE LIVES: Clean Your Hands, especially heading to 5 May, by disseminating cascade messaging to their contacts/members and featuring on their web pages. Among these, the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), the Centers for Disease Control and Prevention (CDC), the International Federation for Infection Control (IFIC), the Association for Professionals in Infection Control & Epidemiology (APIC), the Infection Prevention and Control African Network (IPCAN). It is a long-term objective and indeed critical for the campaign's existence to have key organizations and other stakeholders feature information and promote action on 5 May, year on year, and closely collaborate with WHO Clean Care is Safer Care to reduce health care-associated infection worldwide. Their actions are acknowledged by WHO on the SAVE LIVES: Clean Your Hands pages.

It was clear, however, that for sustainability of the campaign, support for action at the point of patient care would be critical and WHO Clean Care is Safer Care established ways of directly engaging health-care facilities in such action.

Moment 1 Global Survey indicator

In 2010, to begin the move from demonstrating commitment to true action, a global survey of hand hygiene compliance with Moment 1 ('Before touching a patient') of the WHO "My 5 Moments for Hand Hygiene", was announced, the first of its kind. More than 300 facilities from 47 countries took part in this survey and results have been presented as per the six WHO regions, as well as individual participants receiving feedback on their own data

Use of the WHO Hand Hygiene Self-Assessment indicator

After two years of SAVE LIVES: Clean Your Hands, it is now time for health-care facilities around the world to move from commitment to action at the point of care. Tracking progress, planning actions and aiming for hand hygiene improvement and sustainability are the goals for 5 May 2011. To help health-care facilities do this, WHO recommends the use of the WHO Hand Hygiene Self-Assessment Framework.

The Framework was first published on 5 May 2010 with the aim of helping health-care facilities obtain a situation analysis of their hand hygiene promotion and practices and understand their progress with hand hygiene sustainability. WHO is coordinating collection of data related to the Framework completion from a sample of registered facilities and national campaigns in order to gather a global picture of hand hygiene improvement progress. The benefits of using the Framework are clear and presented on the WHO web pages where the tool can be downloaded. Use of this tool year on year will represent a significant component of keeping health-care facility hand hygiene actions alive.

WHO Hand Hygiene Tool downloads indicator

A broad range of more than 30 tools to support hand hygiene improvement are available on the WHO SAVE LIVES: Clean Your Hands web site:

Access and tool download information have been gathered. In summary, a number of the WHO hand hygiene tools, are proving to be popular on an ongoing basis. The posters, 'How to hand wash' and 'Your 5 Moments for Hand Hygiene' as well as the hand hygiene observation form are examples of these and the Hand Hygiene Self-Assessment Framework is currently second only to the 'How to hand wash' poster in downloads, reaching almost 30 000 by March 2011. These tools have been translated into French, Spanish and Arabic as well as several non official WHO languages and adapted for local use.

A number of indicators demonstrate that the WHO SAVE LIVES: Clean Your Hands global campaign has gathered very enthusiastic participation worldwide. The current evaluation of the progress of hand hygiene promotion and practices at the facility level through the use of the WHO Hand Hygiene Self-Assessment Framework, will help further assess its impact at the bed side.