The Joint Commission releases an educational monograph: Measuring Hand Hygiene Adherence: Overcoming the Challenges.
MedSun: Newsletter #37, June 2009

The Joint Commission

Preventing infections is critical to patient safety. Effective hand hygiene practices have long been recognized as the most important way to reduce the transmission of potentially deadly microorganisms in health care settings. But it is critical to follow-up the implementation of hand hygiene policies and protocols with evaluative monitoring of their effectiveness.

To help health care organizations target their efforts in measuring hygiene performance, The Joint Commission (JC) has released “Measuring Hand Hygiene Adherence: Overcoming the Challenges.” In addition to the JC, the collaborating organizations participating in developing the monograph included the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC), the Centers for Disease Control and Prevention (CDC), the Society for Healthcare Epidemiology of America (SHEA), the World Health Organization (WHO) World Alliance for Patient Safety, the Institute for Healthcare Improvement (IHI) and the National Foundation for Infectious Diseases (NFID).

In 2004, The World Health Organization (WHO) World Alliance for Patient Safety initiated a global response to the problem of health care–associated infection, with a major emphasis on the promotion of hand hygiene in health care. Many of the measurement and improvement tools developed for initiatives within and across countries are publicly available (links thereto are provided in the monograph); are widely field tested; and are well worth considering for use in your organization.

The report provides a critical appraisal, including the advantages and disadvantages, of the three main methods for measuring hand hygiene performance, which are:

• Directly observing
• Measuring product use
• Conducting surveys

Simple charts and graphs can make data—such as data on when health care workers clean their hands and how they clean their hands—easy to interpret and use. A quality dashboard can provide an organization’s leadership with a quick, at-a-glance summary of structure, process, and outcome. It is useful to stratify data by subgroups, such as specific hand hygiene opportunities or types of health care workers. Statistical process control charts are useful for revealing trends in data over time and can help you determine whether changes in rates are a result of specific interventions or due to normal variation.

Additional Information:

Measuring Hand Hygiene Adherence: Overcoming the Challenges. The Joint Commission. April 14, 2009.

Measuring Hand Hygiene Adherence: Overcoming the Challenges. Hand Hygiene Monograph. Available:

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