Executive Summary Checklist
In order to establish a program to improve hand hygiene and reduce healthcare-associated infections (HAIs), the following implementation plan will require actionable steps. The following checklist was adapted from the WHO Hand Hygiene Self-Assessment Framework \cite{2010a} and based on research studies in which sustainable improvement was achieved \cite{Bouk_2016} \cite{Kelly_2016}\cite{Son_2011}\cite{Robinson_2014}.
- Gain commitment from senior leadership to make hand hygiene compliance an organizational priority by setting clear requirements and an adequate budget for:
- Staff Performance
- Performance Measurement and Feedback that is timely and actionable
- Accountability for Performance Improvement at facility and unit leadership levels as part of an overall Organizational Hand Hygiene Guideline. Cascade this message to the entire organization on an on-going basis.
- Ensure that alcohol-based hand rubs and soap are available as close to the point of care as is reasonable.
- Establish a hand hygiene team responsible for implementation of the Hand Hygiene Protocol.
- The protocol should include mandatory training for all healthcare workers (HCWs) upon hire and on-going at least once annually. Training to include:
- Proper technique for hand rubbing and soap and water washing
- Indications for hand rubbing vs soap and water washing (WHO or CDC Guideline)
- How to speak up when fellow HCWs do not comply (psychological safety is a vital condition of an effective safety culture)
- Education for patients, family members and visitors.
- Performance Evaluation and Feedback
- It is essential to measure hand hygiene compliance accurately and reliably using a validated method capable of capturing and reporting on 100% of all hand hygiene events such as an evidence-based electronic hand hygiene compliance system. Such systems have been shown to lead to sustainable improvement, reduced infections & costs and a positive impact on patient safety culture \cite{Bouk_2016} \cite{Kelly_2016}\cite{Michael_2017}\cite{Son_2011}.
- Measure hand hygiene compliance using an evidence-based, validated electronic hand hygiene compliance system.
- Provide performance feedback to unit leadership and frontline staff on a daily or weekly basis using evidence-based behavior change feedback models \cite{21775022}.
- Follow technology suppliers’ evidence-based recommendations for how to best implement technology and provide timely feedback to healthcare workers.
- Reminders in the workplace such as posters, brochures, leaflets, badges, stickers, etc. can be used provided they are consistent with the overall Hand Hygiene Protocol and any organizational wide campaigns to focus attention on the importance of hand hygiene.