Research for infection protection

World Hand Hygiene Day 2019:
The core elements of infection prevention

On this year's World Hand Hygiene Day, the World Health Organization (WHO) is focusing on measures that it has identified as core elements of prevention against nosocomial infections.

The WHO core elements for infection prevention can be implemented step by step with HARTMANN's Hand Hygiene Evolution Concept—which offers modern tools such as eHealth applications for monitoring hand hygiene compliance, eLearning programmes and flexible operation procedures.

The eight most important WHO core elements for the prevention of nosocomial infections and the containment of multi-resistant pathogens as well as how the Hand Hygiene Evolution Concept supports the implementation:

1) Infection prevention and control programmes
Implementation of an infection prevention and control program (IPC program) with clearly defined goals and an annual work plan. The IPC programme should:

  • be supported by a trained and committed team
  • consider local epidemiology and priorities according to institution-specific risk assessments
  • have a budget and resources
  • include measurable outcome indicators and targets for critical health care


2) Evidence-based guidelines
Evidence-based guidelines should be developed, or existing guidelines should be implemented in healthcare facilities:

  • adaptation to local conditions should be considered
  • compliance with guidelines should be monitored
  • relevant stakeholders (senior physicians, nursing staff, healthcare facility managers) should be involved in the development and adaptation of policies

The Hand Hygiene Evolution Concept is supported by materials that are based on scientific principles and are continuously adapted to new standards.


3) Education and training

The training of all healthcare workers on infection control issues should be part of a comprehensive education strategy for healthcare facilities:

  • use of team and task-based methods that are participatory and include eLearning programmes, bedside teaching and simulation training
  • regular evaluation of the effectiveness of the training, at least once a year
  • checks on the knowledge acquired, e. g. through hygiene audits

The Hand Hygiene Evolution Concept provides support with sophisticated eLearning programmes, eHealth applications for compliance monitoring and attractive slides for classroom training.


4) Healthcare-associated infection surveillance

The institution-specific monitoring of nosocomial infection helps to identify the most common infections and outbreaks:

  • surveillance results should be reported in a timely manner
  • results and findings of national surveillance networks serve as a basis for interventions to protect against infection
  • sufficient microbiological laboratory capacity should be available for surveillance


5) Multimodal strategies
Multimodal strategies are scientifically proven to be the best approach to achieve behavioural change and better compliance with infection control measures:

  • instead of one strategy (training and education), a number of strategies are used to address human behaviour, e. g. through monitoring and feedback, improvement of infrastructures or the safety culture

The Hand Hygiene Evolution Concept provides support with a multimodal, modular overall concept.


6) Monitoring and feedback

Regular monitoring and timely feedback on the employees’ compliance with infection control measures is an important instrument to convince employees that there is a problem and that the chosen solution is the right one:

  • timely feedback to all persons who have been observed
  • monitoring hand hygiene and compliance is a key indicator of the status of infection prevention
  • monitoring and feedback contribute to creating a learning culture

The Hand Hygiene Evolution Concept provides support with modern eHealth applications for compliance monitoring, feedback and for the high-quality presentation of results.


7) Staffing and bed occupancy
Overcrowding and overwork increase the risk of infection and outbreaks. Bed occupancy and staffing should be in line with standard capacity:

  • workload, staffing and bed occupancy should be taken into account
  • for bed occupancy, there should be sufficient space (>1 metre between the patient beds)

The Hand Hygiene Evolution Concept provides support with structured procedures and checklists.


8) Environment and equipment considering infection control
To ensure patient safety, care should be provided in a hygienic environment with access to all necessary utensils.

  • provision of all equipment necessary for infection protection, e. g. hand disinfectants at the point of care
  • sufficient technical equipment, e. g. dispenser systems

The eight components of WHO are the prerequisite for successfully establishing infection prevention and control programmes in healthcare facilities. With its handbook published in 2018, WHO helps hospitals, for example, to establish these key infection control measures in their facilities [1].

The Hand Hygiene Evolution Concept provides support with dispenser systems for any room situation and evidence-based dispenser checklists.

1. World Health Organization (WHO). Improving Infection Prevention and Control at the Health facility. Interim practical manual supporting implementation of the WHO Guidelines on Core Components of Infection Prevention and Control Programmes. Genf 2018.