Access the full text.
Sign up today, get DeepDyve free for 14 days.
Loading next page...
/lp/springer-journals/scenario-based-simulation-training-for-the-who-hand-hygiene-self-5fjA0xENtv
- Publisher
- Springer Journals
- Copyright
- Copyright © 2019 by The Author(s).
- Subject
- Biomedicine; Medical Microbiology; Drug Resistance; Infectious Diseases
- eISSN
- 2047-2994
- DOI
- 10.1186/s13756-019-0511-9
- Publisher site
- See Article on Publisher Site
Abstract
The WHO SAVE LIVES: Clean Your Hands global hand hygiene campaign, launched in 2009 and celebrated annually on the 5th of May, features specific calls to action seeking to increase engagement from stakeholders’ collaborations in hand hygiene improvement. WHO calls on everyone to be inspired by the global movement towards universal health coverage (UHC). Infection prevention and control (IPC), including hand hygiene, is critical to achieve UHC as it has a direct impact on quality of care and patient safety across all levels of the health services. In the framework of UHC, the theme for 5 May 2019 is “Clean care for all – it’sin yourhands”. In this context, the WHO has launched a global survey to assess the current level of progress of IPC programmes and hand hygiene activities in healthcare facilities (HCFs) worldwide. This involved the creation of two tools for healthcare facilities: the WHO Infection Prevention and Control Assessment Framework (IPCAF) and the WHO Hand Hygiene Self-Assessment Framework (HHSAF). The objective of this paper is to provide case scenario-based simulation for IPC specialists to simulate and fully assimilate the correct completion of the HHSAF framework in a standardized format. The three case scenarios have been tested and are proposed for the reader to assess the HHSAF of different HCFs in a variety of contexts, even in low-resouce settings. They were designed for simulation training purposes to achieve standardization and interactive learning. These scenarios are meant to be used by professionals in charge of implementing a hand hygiene improvement strategy within their HCF, as well as for simulation and standardized training purposes prior to completing and submitting data for the 2019 WHO Global Survey. Additionally, information provided by the use of the HHSAF can easily be translated into action plans to support the implementation and improvement related to specific indicators of hand hygiene promotion. We invite all HCFs to participate in the 2019 WHO global survey and monitor the level of progress of their IPC programme andhandhygiene activities. Keywords: Simulation, Education, Infection prevention and control, Hand hygiene, Healthcare-associated infection, Antimicrobial resistance, Multimodal promotion, Universal health coverage, Quality, Patient safety, World Health Organization Background transmission and control of multidrug-resistant organ- Too many of the vulnerable individuals admitted to isms in health care settings are critical as the number of health-care settings develop a health-care associated in- antibiotics available to treat these infections is limited fection (HAI). This results in increased morbidity and [3]. Many of these issues could be prevented through mortality, prolonged hospital stay, and financial losses simple, low-cost infection prevention and control (IPC) for health care systems [1, 2]. Additionally, prevention of measures such as hand hygiene performed at critical moments [4, 5]. The focus of the World Health Organization (WHO) * Correspondence: Didier.Pittet@hcuge.ch SAVE LIVES: Clean Your Hands global campaign has Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue been to promote best hand hygiene practices as a key Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland component of achieving quality of care and patient Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Tartari et al. Antimicrobial Resistance and Infection Control (2019) 8:58 Page 2 of 6 safety [6–11]. This campaign, launched in 2009 and cele- Assesing the level of hand hygiene at your institution brated annually on the 5th of May, features specific calls Measuring, promoting, improving, and subsequently sus- to action each year, and seeks to increase engagement taining hand hygiene standards as quality indicators for from stakeholders’ collaborations in strenghtening IPC patient safety is essential [18]. To advance this agenda, it programmes and improving hand hygiene. This year’s is crucial to monitor where improvements have occurred campaign theme is “Clean care for all – it’s in your and gaps must be addressed in hand hygiene structures, hands” [11](https://www.who.int/infection-prevention/ processes, resources, promotion and practices [19, 20]. campaigns/clean-hands/en/). WHO provides a range of tools and resources to sus- ‘Health for All’ has been increasingly recognized in tain hand hygiene improvement. One is the Hand Hy- international fora as a concept firmly based on equity. giene Self-Assessment Framework (HHSAF), which is a Alongside a strong global momentum surrounding validated tool used to quantify the status of hand hy- universal health coverage (UHC), WHO calls on giene promotion activities within healthcare facilities everyone to contribute to the attainment of health for worldwide [14, 15]. Launched by WHO in 2010, the all populations [12]. In the context of UHC, IPC with HHSAF is available in different languages; it remains the hand hygiene as a fundamental measure, is a key most widely used tool and the only framework aimed at component in providing patient safety and high qual- tracking the level of progress of healthcare facilties in ity health services [12, 13]. the context of hand hygiene implementation. Structured around the five components of the WHO Multimodal Hand Hygiene Improvement Strategy (see Appendix), The 2019 WHO global survey the HHSAF assesses the interventions implemented by The WHO global survey aims to assess the current level HCFs in the context of their adherence to WHO hand of progress of IPC programmes and hand hygiene activ- hygiene guidelines and recommendations [18–20]. The ities in HCFs in the context of the WHO SAVE LIVES: HHSAF analyses a number of factors within each of the Clean Your Hands annual hand hygiene global campaign five components of the multimodal strategy and scores (https://www.who.int/infection-prevention/campaigns/ institutions’ status as inadequate, basic, intermediate and ipc-global-survey-2019/en/). The survey will be open advanced, according to the number of points obtained until July 2019, and WHO invites all HCFs to join. The (see Appendix). Additionally, it directs HCFs to the survey is based on the use of two tools at the HCF level: WHO hand hygiene promotion tools and the template the WHO Infection Prevention and Control Assessment action plans (available at https://www.who.int/infection- Framework (IPCAF) (https://www.who.int/infection-pre prevention/tools/hand-hygiene/en/) that can be used to vention/tools/core-components/IPCAF-facility.PDF?ua= make improvement plans according to the HHSAF score 1) and the WHO HHSAF (https://www.who.int/gpsc/ and specific indicators identified as requiring attention. country_work/hhsa_framework_October_2010.pdf?ua=1) Given this important focus on hand hygiene in IPC [14, 15] programmes, the WHO previously conducted two global The IPCAF is a validated assessment tool that sup- surveys using the HHSAF in 2011 and 2015, inviting ports the implementation of the WHO recommenda- HCFs worldwide to submit their self-assessments [21]. tions on the core components of effective IPC The two surveys offered a bird’s eye view of hand hy- programmes [16] at the acute HCF level. The goal of the giene programmes at the HCF level and enabled better framework is to assess the current IPC situation in comparisons across regions and over time, prompting HCFs. It is especially focused on evaluating existing IPC calls for further improvements. In 2011, the majority of activities/resources, and identifying strengths and gaps HCFs participating were from developed countries and that can inform future policies. It can be considered as a reflected an intermediate level of progress. When the diagnostic tool for HCFs to detect relevant problems or survey was repeated in 2015, the overall score increased shortcomings that require improvement as well as iden- significantly (p < 0.001) in the 86 HCFs that participated tify areas where international standards and require- in both surveys [21]. Improvement was documented in ments can be met [16, 17]. all regions, particularly in the Eastern Mediterranean re- The HHSAF is a systematic tool with which an gion, Europe and the Americas. The African region individual health-care facility can obtain a situational scored lowest, which could be indicative of a poorer IPC analysis of its hand hygiene promotion and practices infrastructure, resources and basic knowledge in hand [14, 15]. To guide future improvement WHO is launch- hygiene implementation and issues concerning sustain- ing the HHSAF again in 2019 as part of the WHO glo- ability. The disparities that emerged from the two global bal survey (the HHSAF was previously launched in HHSAF surveys emphasize the need for additional im- 2011 and 2015) (https://www.who.int/infection-preven provement of hand hygiene practices, especially in tion/campaigns/ipc-global-survey-2019/en/). low-resource settings. Tartari et al. Antimicrobial Resistance and Infection Control (2019) 8:58 Page 3 of 6 Supporting hand hygiene education and training completing and submitting data for the 2009 WHO Glo- To support education and training activities around the bal Survey. As proposed by the WHO Guide to Imple- global survey, WHO, together with the WHO Collabor- mentation, information provided through the use of the ating Centre on Patient Safety, developed a body of ma- HHSAF should be translated into action plans to sup- terial including an educational video (available at https:// port the implementation and improvement related to www.youtube.com/watch?v=PDz8kxrPaMk&feature=you specific indicators of hand hygiene promotion [19, 20]. tu.be), a promotional video (available at https://www. HCFs worldwide should consider implementing a system youtube.com/watch?v=UfH6ODLV3BI) and three case of continuous assessment of hand hygiene improvement scenario-based simulations (Tables 1, 2 and 3) for IPC strategy [21] by utilizing the HHSAF tool systematically; specialists to simulate and fully assimilate the correct the current recommendation by WHO and experts is to completion of the HHSAF framework in a standardized use it at least annually. format. Simulation in health care is widely used in med- Information appropriate for each of the WHO Multi- ical education as an active learning method and it has modal Hand Hygiene Improvement Strategy compo- been shown to have great potential [22–24]. nents has been identified in the case scenarios (Tables 1, The case scenarios presented here can be used by pro- 2 and 3). In order to simulate the completion of the fessionals in charge of implementing a hand hygiene im- HHSAF, they provide details regarding HH promotion provement strategy within their facility, as well as for strategy for the evaluation of resources, promotion, and simulation and standardized training purposes prior to practices within a given HCF. The three case scenarios Table 1 Case Scenario 1 to simulate the completion of the WHO Hand Hygiene Self Assessment Framework (HHSAF) Case Scenario HHSAF Component Subtotal Score The Bellevue University Medical Centre is a tertiary care institution with 1000 beds and three separate campuses. Hand hygiene (HH) products including alcohol-based hand rubs (ABHR) are available System Change 90/100 facility-wide with continuous supply and at the point of care. There are one to three sinks in every patient’s room together with non-medicated soap, paper towels and alcohol-based hand rub dispensers with proven efficacy and tolerability. The HH promotion strategy is based on the World Health Organization (WHO) 5 Moments Training and Education 90/100 for Hand Hygiene and includes mandatory HH training upon employment and at least annually for all health workers by trained and validated Infection Prevention and Control (IPC) practitioners. All WHO training materials are made available in the hospital’s intranet. Non-attendance is directly linked to closed access to the hospitals’ informatics systems. Availability of HH products (ABHR, soap, single use paper towels) is audited on a regular basis. Evaluation and 75/100 A quarterly schedule of HH compliance monitoring has been established (Periods 1–4), Feedback and is conducted by validated IPC practitioners. Immediate feedback to health workers is encouraged. In 2012, 10,000 HH opportunities and 3740 actions were observed. In 2017, 10,000 HH opportunities and 6700 actions were observed. HH compliance before patient contact is 10–15% lower than after patient contact. HH compliance was highest among nursing staff (73.6%) and lower among medical staff (52.3%). The use of ABHR accounts for the majority of HH actions performed in the facility. Visual reminders in the form of posters on “My 5 Moments for Hand Hygiene” and HH technique are Reminders in the 47.5/100 displayed in strategic clinical areas within the health care facility. On admission, patients are provided workplace with a brochure about the importance of HH and posters promoting patient participation are displayed in patient areas. There is no system in place to update posters regularly, however. The IPC/hand hygiene team (one full-time doctor and five full time nurses) have been implementing Institutional Safety 65/100 a HH culture-change program for the past five years, spearheaded by hospital’s leadership and leading Climate a country wide national HH initiative aiming to improve health care workers’ HH compliance, increase use of ABHR and reduce HAIs. The hospital celebrates the world HH day on the 5th of May. A process that provides HH compliance performance feedback (every six months) is in place, and is driven and supported by the hospital leadership. High performing wards are publicly recognized within the hospital and their HH compliance levels set the HH targets for the following year. The hospital has a system of HH champions in all medical, surgical and high-risk wards. Bloodstream infections (BSI), surgical site infections (SSI) and MRSA clinical cultures are monitored Leadership 10/20 in high-risk areas and facility wide, and a point prevalence survey of HAIs is performed annually. A decrease in overall HAIs (prevalence of 17.3% in 2000 to 9.4% in 2015) was reported, MRSA transmission rates decreased (2.16 to 0.93 episodes per 10,000 patient-days), and the consumption of ABHR increased from 12.5 to 22.4 L per 1000 patient-days in the past five years. HAI data are presented regularly to hospital leadership and to health workers together with HH compliance rates. Total Score 377.5/500 Abbreviations: ABHR Alcohol-based handrub, BSI Bloodstream infections, HAIs Healthcare-associated infections, HH Hand hygiene, MRSA Methicillin-resistant Staphylococcus aureus, SSI Surgical site infections Tartari et al. Antimicrobial Resistance and Infection Control (2019) 8:58 Page 4 of 6 Table 2 Case Scenario 2 to simulate the completion of the WHO Hand Hygiene Self Assessment Framework (HHSAF) Case Scenario HHSAF Subtotal Score Component St. Mary’s Teaching Hospital is a large tertiary care institution with 550 beds in rural Uganda. The hospital has 24 clinical wards, including radiology, laboratory, and pharmacy services. One-liter ABHR bottles are mounted on the walls of the wards for ease of access. Mobile bottles are also placed System Change 10/100 on the trolleys used for ward rounds, in the reception area and in the treatment room area. The ABHR used was locally produced from sugar cane. Local ABHR production and quality control have proven to be feasible and satisfactory. Hand hygiene supplies are scarce. Only one or no functional sinks/taps were available in each ward. Portable water bottles and basins are an alternative for handwashing. Gloves, even non-sterile ones, are rarely available. An action plan has recently been developed to improve the infrastructure in the hospital. HH education and training for health workers is sporadic and mainly occurs upon initial employment. The training Training and 20/100 is provided by the IPC nurse who has received training from the Infection Control Africa Network (ICAN) Education HH compliance rate is monitored by direct observations using the WHO hand hygiene monitoring tool, Evaluation and 10/100 however there is no established HH promotion strategy; observations are conducted annually. The HH compliance Feedback rate was very low. In 2015, the overall reported compliance was 9.2%, but by 2017 it had increased to 21.8%. The WHO ‘How to handwash’, ‘How to handrub’ and ‘My 5 Moments for Hand Hygiene’ posters were Reminders in 25/100 only available in some of the hospital wards. the workplace No IPC team, or experts in infection control is available in the country, although one part-time infection control Institutional 15/100 nurse has been assigned infection control duties in the hospital. The director of nursing is committed to supporting Safety Climate hand hygiene improvement at St Mary’s hospital. Since 2017, the hospital is engaged in the WHO Save Lives Clean Your Hands annual campaign and is celebrating the 5th of May global HH day. Total Score 80/500 Abbreviations: ABHR Alcohol-based handrub, HH Hand hygiene took in consideration a range of HCFs around the world four levels of hand hygiene implementation progress in a variety of contexts, regardless of the resources avail- (see Appendix). The HCF presented in Table 1 scored as able. Drawing from the information provided, a score is Advanced, and can therefore undergo further Leadership assigned for each component and section. The sum of assessment according to twenty additional criteria, but the maximum values in each section is 100 points, add- since only ten of them have been met, the HCF is not ing up to a maximum overall score of 500 points. Based classified as having reached the Leadership level. Infor- on the overall score, a HCF is then assigned to one of mation for baseline evaluation of hand hygiene activities Table 3 Case Scenario 3 to simulate the completion of the WHO Hand Hygiene Self Assessment Framework (HHSAF) Case Scenario HHSAF Subtotal Score Component The Ulwazi National Referral Hospital is a national referral and teaching tertiary care institution with 900 beds providing both primary and specialized health care (maternity, hemodialysis, intensive care units, medical and surgical specialties). HH supplies (i.e. ABHR, soap and disposable towels) are scarce in the facility, with the availability of ABHR being System Change 10/100 confined to specialty areas such as Maternity, Hemodialysis and Intensive Care Units. The ABHR efficacy and tolerability have not been proven. The other wards use soap for handwashing and do not have disposable paper towels. Soap supplies are erratic and, at times, not available. The soap is very harsh to the skin. The wards have sinks with running water. The sinks are installed in the following areas in the ward: � 1 in the nursing station� 1in the procedure/treatment room� 2 sinks per ward (25 beds) � 1 sink for the patient wash and toilet areas HH training is done as part of in-service education, upon employment. When newly employed staff members are Training and 50/100 trained in HH, they enter their names and signatures in a register, kept as a record that all HCWs completed the Education training. Student nurses are given the HH training in their 1st and 3rd year of undergraduate education. The student nurses are attached for clinical practice in the hospital and have contact with the patients from the first year. The WHO leaflets on ‘Glove Use Information’ and “Hand Hygiene: Why, How and When” are available. Audits to assess the availability and consumption of HH products is not performed, as the hospital lacks human Evaluation and 0/100 resources. HH compliance rates are not monitored. The IPC nurse has not been trained as a hand hygiene Feedback compliance observer. Posters displaying the WHO ‘My 5 Moments of Hand Hygiene’, ‘How to Hand Rub’ and ‘How to handwash’ are Reminders in 50/100 displayed next to all the hospital’s sinks. the workplace The Ulwazu facility has registered for the WHO Clean Care is Safer Care global campaign and is commemorating Institutional Safety 10/100 the Hand Hygiene Day every 5th of May. Climate Total Score 120/500 Abbreviations: ABHR Alcohol-based handrub, HH Hand hygiene Tartari et al. Antimicrobial Resistance and Infection Control (2019) 8:58 Page 5 of 6 within a lower income setting is presented in Table 2; Acknowledgements We thank healthcare facilities for providing helpful information for the case based on the overall score, the HCF would be assigned scenarios. as Inadequate level of progress. The HCF in Table 3 is assigned to Basic level, identifying the need for signifi- Funding This work is supported by the World Health Organization (WHO), Geneva, cant improvement. The use of HHSAF over time will en- Switzerland, and the Infection Control Programme and WHO Collaborating able HCFs to keep track of their progress and Centre on Patient Safety (SPCI/WCC), University of Geneva Hospitals and continuously set new targets for improvement. Faculty of Medicine, Geneva, Switzerland; hand hygiene research activities at the SPCI/WCC are also supported by the Swiss National Science Foundation (grant no. 32003B_163262). Conclusion Availability of data and materials Not applicable. The foremost objective of the WHO global annual cam- paign is to prioritize IPC in health care and the global Declarations health agenda, with hand hygiene assessment and im- The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions or policies of the provement playing a fundamental role in ensuring pa- institutions with which they are affiliated. WHO takes no responsibility for the tient safety. We invite all HCFs to be actively engaged in information provided or the views expressed in this paper. this important endeavour and call upon all those who Authors’ contributions can contribute towards achieving high-quality health All authors critically reviewed the contents of the manuscript and approved care and universal health coverage for the improvement the final version. All authors did final editing and approval. Ethics approval and consent to participate Appendix Not applicable. Hand Hygiene Self-Assessment Framework Table 4 Levels of Hand Hygiene Implementation Progress Defined Consent for publication Not applicable. by the WHO Hand Hygiene Self-Assessment Framework (HHSAF) Level of Progress HHSAFScore Definition Competing interests All listed authors declare no financial support, grants, financial interests or Inadequate 0–125 Hand hygiene practices and promotion consultancy that could lead to conflicts of interest. Didier Pittet works with are deficient. Significant improvement WHO in the context of the WHO initiative ‘Private Organizations for Patient is required Safety – Hand Hygiene’. The aim of this WHO initiative is to harness industry Basic 126–250 Some measures are in place, but not at strengths to align and improve implementation of WHO recommendations a satisfactory standard. Further for hand hygiene in health care in different parts of the world, including in improvement is required least developed countries. In this instance, companies/industry with a focus on hand hygiene and infection control related advancement have the Intermediate 251–375 An appropriate hand hygiene specific aim of improving access to affordable hand hygiene products as promotion strategy is in place, and well as through education and research. hand hygiene practices have improved. It is now crucial to develop long-term plans to ensure that improvement is Publisher’sNote sustained and progresses Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Advanced 376–500 Hand hygiene promotion and optimal hand hygiene practices have been Author details sustained and/or improved, helping to Infection Control Programme and WHO Collaborating Centre on Patient embed a culture of safety in the Safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue healthcare setting Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland. Institute of Global Leadership The healthcare facility is considered as Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland. a reference center for and contributes 3 Department of Nursing, Faculty of Health Sciences, University of Malta, to the promotion of hand hygiene 4 Msida, Malta. Infection Control Africa Network, Unit of IPC, Tygerberg through research, innovation and 5 Hospital, Cape Town, South Africa. Infection Prevention and Control Global information sharing Unit, Department of Service Delivery and Safety, World Health Organization, Geneva, Switzerland. Department of Infectious Diseases, Centro Hospitalar The healthcare facility reached the Advanced level and in addition meets at least 12 out of 20 leadership criteria and at least one leadership criterion per Lisboa Norte and Faculdade de Medicina da Universidade de Lisboa, Lisbon, each category Portugal. Received: 13 March 2019 Accepted: 19 March 2019 of public health worldwide. “Clean care for all – it’s in your hands” References 1. Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in Abbreviations developing countries: systematic review and meta-analysis. Lancet. 2011; HAI: Health-care associated infection; HCF: Health care facility; HHSAF: Hand 377:228–41. Hygiene Self-Assessment Framework; IPC: Infection Prevention and Control; 2. Marchetti A, Rossiter R. Economic burden of healthcare-associated IPCAF: Infection Prevention and Control Assessment Framework; infection in US acute care hospitals: societal perspective. J Med Econ. UHC: Universal Health Coverage; WHO: World Health Organization 2013;16:1399–404. Tartari et al. Antimicrobial Resistance and Infection Control (2019) 8:58 Page 6 of 6 3. World Health Organization. Evidence of hand hygiene to reduce transmission and infections by multi drug resistant organisms in health-care settings. 2014; Available at: (https://www.who.int/gpsc/5may/MDRO_ literature-review.pdf ). Accessed 20 Feb 2019. 4. Pittet D, Allegranzi B, Sax H, Dharan S, Pessoa-Silva CL, Donaldson L, et al. Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis. 2006;6:641–52. 5. Pittet D, Dharan S, Touveneau S, Sauvan V, Perneger TV. Bacterial contamination of the hands of hospital staff during routine patient care. Arch Intern Med. 1999;159:821–6. 6. World Health Organization. WHO guidelines on hand hygiene in health care: first global patient safety challenge clean care is safer care. Geneva: World Health Organization; 2009b. 7. World Health Organization. Global action plan on antimicrobial resistance. 2015; Available at: http://apps.who.int/iris/handle/10665/193736 . Accessed 30 Jan 2019. 8. 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 Infect. 2007;67:9–21. 9. Allegranzi B, Pittet D. Role of hand hygiene in healthcare-associated infection prevention. J Hosp Infect. 2009;73:305–15. 10. Pittet D, Donaldson L. Clean care is safer care: a worldwide priority. Lancet. 2005;366:1246–7. 11. WHO | SAVE LIVES: Clean Your Hands. WHO Available at: http://www.who.int/ infection-prevention/campaigns/clean-hands/en/ . (Accessed: 27 Feb 2019). 12. WHO | What is universal coverage? WHO Available at: http://www.who.int/ health_financing/universal_coverage_definition/en/ . Accessed: 28 Feb 2019. 13. Storr J, Kilpatrick C, Allegranzi B, Syed SB. Redefining infection prevention and control in the new era of quality universal health coverage. J Res Nurs. 2016;21(1):39–52. 14 World Health Organization. Hand Hygiene Self-Assessment Framework; 2010. https://www.who.int/gpsc/country_work/hhsa_framework_October_ 2010.pdf?ua=1. Accessed 22 Feb 2019. 15 Stewardson AJ, Allegranzi B, Perneger TV, Attar H, Pittet D. Testing the WHO hand hygiene self-assessment framework for usability and reliability. J Hosp Infect. 2013;83:30–5. 16 World Health Organization. Guidelines on core components of infection prevention and control programmes at the national and acute care facility level. 2016; Available at: https://www.who.int/infection-prevention/tools/ core-components/en/ . Accessed 20 Feb 2019. 17 World Health Organization. Infection Prevention and Control Assessment Framework at the Facility Level; 2018 https://www.who.int/infection-prevention/ tools/core-components/IPCAF-facility.PDF?ua=1 . Accessed 22 Feb 2019. 18. Allegranzi B, Gayet-Ageron A, Damani N, Bengaly L, McLaws ML, Moro ML, et al. Global implementation of WHO's multimodal strategy for improvement of hand hygiene: a quasi-experimental study. Lancet Infect Dis. 2013;13:843–51. 19. World Health Organization. Guide to implementation of the WHO multimodal hand hygiene improvement strategy. Geneva: World Health Organization; 2009a. 20. Allegranzi B, Pittet D. WHO Multimodal Promotion Strategy. In: Pittet D, Boyce J, Allegranzi B, editors. Hand Hygiene: A Handbook for Medical Professionals. Chichester: Wiley; 2017. p. 357–66. 21. Kilpatrick C, Tartari E, Gayet-Ageron A, Storr J, Tomczyk S, Allegranzi B, et al. Global hand hygiene improvement progress: two surveys using the WHO hand hygiene self-assessment framework. J Hosp Infect. 2018;100:202–6. 22. Nakamura I, Fujita H, Tsukimori A, Kobayashi T, Sato A, Fukushima S, Amano K, Abe Y. Scenario-based simulation health care education for performance of hand hygiene. American journal of infection control. 2019;47(2):144–8. 23. Cartier V, Inan C, Zingg W, Delhumeau C, Walder B, Savoldelli GL. Simulation- based medical education training improves short and long-term competency in, and knowledge of central venous catheter insertion: a before and after intervention study. Eur J Anaesthesiol (EJA). 2016;33(8):568–74. 24. Barsuk JH, Cohen ER, Feinglass J, McGaghie WC, Wayne DB. Use of simulation-based education to reduce catheter-related bloodstream infections. Arch Intern Med. 2009;169(15):1420–3.
Journal
Antimicrobial Resistance & Infection Control – Springer Journals
Published: Mar 28, 2019