![]() The five essential elements are: system change, including availability of alcohol-based handrub at the point of patient care and/or access to a safe, continuous water supply and soap and towels training and education of health-care professionals monitoring of hand hygiene practices and performance feedback reminders in the workplace and the creation of a hand hygiene safety culture with the participation of both individual HCWs and senior hospital managers. At its core is a multimodal strategy consisting of five components to be implemented in parallel the implementation strategy itself is designed to be adaptable without jeopardizing its fidelity and is intended therefore for use not only in virgin sites, but also within facilities with existing action on hand hygiene. The implementation strategy has been informed by the literature on implementation science, behavioural change, spread methodology, diffusion of innovation, and impact evaluation. The Guide to Implementation accompanies the WHO Guidelines on Hand Hygiene in Health Care and outlines a process for fostering hand hygiene improvement in a health-care facility. ![]() The WHO Multimodal Hand Hygiene Improvement Strategy consists of a Guide to Implementation and a range of tools constructed to facilitate implementation of each component. Based on the best available scientific evidence and underpinned by both the long-standing expertise of Geneva’s University Hospitals to promote multimodal hand hygiene promotion campaigns 60 and learning from the England & Wales National Patient Safety Agency (NPSA) clean your hands campaign, the WHO Hand Hygiene Implementation Strategy has been constructed to provide users with a ready-to-go approach to translate the WHO Guidelines on Hand Hygiene in Health Care into practice at facility level. 868 Fraser describes implementation as being concerned with the movement of an idea that works across a large number of people (the target population). 728, 878Įnsuring that guidelines are transformed from a static document into a living and influential tool that impacts on the target practice requires a carefully constructed strategy to maximize dissemination and diffusion. For this objective to be fulfilled, a successful dissemination and implementation strategy is required to ensure that practitioners are aware of the guidelines and their use. ![]() 869 The literature confirms that there is no magic solution to guarantee uptake and assimilation of guidelines into clinical practice.Īgainst this background, the WHO Guidelines on Hand Hygiene in Health Care have been developed with the ultimate objective of changing the behaviour of individual HCWs to optimize compliance with hand hygiene at the recommended moments and to improve patient safety. 877 Recent work has also focused on knowledge transfer, often incorporating learning from the body of knowledge on diffusion of innovation. 876 The Replicating Effective Programs (REP) framework is one example of a successful approach, although largely within the context of HIV prevention interventions. The successful implementation of guidelines into practice continues to elude health improvement efforts globally.
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