World Hand Hygiene Day (WHHD) 2024: Innovative training stories

Hand hygiene is an important measure in health care that can help prevent infections, unnecessary treatment, and death. On 5 May each year, WHO and its partners around the world mark World Hand Hygiene Day to acknowledge the significance of hand hygiene in helping ensure that everyone has access to safe, effective, and quality health care.

In 2024, World Hand Hygiene Day highlights the importance of health workers sharing their knowledge with their peers and the value of innovative and impactful education and training on infection prevention and control (IPC), including hand hygiene. To facilitate this, WHO made a call for stories that highlight the commitment of IPC practitioners and other health workers around the world to developing and running original, creative and impactful IPC and hand hygiene training.

Many submissions were received and three stories have been selected through a rigorous review process as the best inspiring examples of ongoing effort to improve patient and health worker safety.

Gamifying training

'The Ghost Hygienist' Online Escape Game, The Strasbourg University Hospital, France.

Three years into the COVID-19 pandemic, the IPC Team at The Strasbourg University Hospital noted that health workers were reporting fatigue about IPC recommendations and using less alcohol-based handrub solution.

In response, the IPC team developed an online IPC game. The team used a free website to create an online 'Escape Room' themed around hand hygiene. Players navigated mysterious rooms, thunder and lightning, and side quests whilst testing their knowledge on hand hygiene. The game provided feedback on answers throughout so staff learnt as they played.

With the help of an internal promotional campaign and a lottery prize draw for those who played, the escape game had 1000 visits. Feedback from the hospital staff was very positive, though the nature of the project meant the training could only be accessed via phone, laptop or computer.

Using a game platform meant that the Strasbourg team have been able to analyse the answers and identify common errors and misconceptions regarding hand hygiene. They will use this data to shape future information sharing and training.

Interactive infection, prevention and control learning

Doctors Training Rotation Programme, Radboud University Medical Centre, Nijmegen, The Netherlands.

At Radboud, medical students must take an extensive IPC training programme before starting their clinical rotations. To maintain student engagement the programme uses a range of learning methods, including e-learning, Q&A session, practice stimulation training. The innovation in this approach is the bundling of all of these techniques as part of the programme, as well as the use of virtual reality (VR) technology.

The training is broad, covering everything from the basic principles of IPC measures including hand hygiene, to how to stop the spread of resistant organisms.

The programme has proven to be popular, with 100% attendance among students. In feedback, students say they feel 'ready' to provide the care required while applying IPC principles. Additionally, 98% of the students feel that this training should be part of the core curriculum in all universities.

A Hand Hygiene Observer Masterclass

Fundación Valle del Lili, Cali, Colombia

In health care settings, monitoring hand hygiene practice amongst health workers and providing feedback is vital to ensure IPC standards are implemented. How this feedback is delivered is integral to ensuring best practice implementation and helps maintain a healthy organizational culture. One of the challenges with monitoring is that there can be discrepancies in monitoring activity across and within health care settings.

To address this, the IPC team at Fundación Valle del Lili developed and adapted training for those responsible for monitoring hand hygiene practice in their health facility. These health workers are also known as 'hand hygiene compliance observers' or simply 'observers'. The primary objective of the training is to improve observer knowledge and skills to ensure the consistency and reliability of the data collected.

The first Observer Hand Hygiene Masterclass took place in 2018. The training includes simulation videos of patient care processes, created by the Fundación, so that the observers can test their ability to identify the right moments when hand hygiene should be performed. Emphasis on training in groups and sharing knowledge meant that agreement between observers increased from 55% to 90% in the year that the training was launched. This has led to greater confidence that hand hygiene monitoring practice is consistent within the Fundación.

WHO would like to thank all participants of this training stories competition. All submissions have captured the hard work and commitment to advancing knowledge and training practices in the field of IPC and specifically, hand hygiene. These are just three examples of ongoing efforts of countries and facilities to improve patient and health worker safety.

Further sharing of training strategies by IPC professionals is encouraged by through use of the IPC Global Community of Practice, accessible at https://ipcglobalcommunity.org/. This platform offers a space for people responsible for IPC initiatives at the national, sub-national, or health facility level to:

- access the most up-to-date IPC information via discussion boards and real-time educational opportunities

- engage in knowledge exchange with peers and IPC experts on best practices, and

- strengthen networks to ensure a collaborative and supportive community for successful implementation.

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Competition details

Submissions were carefully assessed through three rounds of review by a select panel of internal and external experts in the field of IPC.

WHO gratefully acknowledges the following external reviewers: Carolina Fankhauser (University of Geneva Hospitals, Geneva, Switzerland), Pamela Lee Yew Fong (Sawak General Hospital, Kuching, Malaysia), Shaheen Mehtar (University of Stellenbosch, Cape Town, South Africa), Seto Wing Hong (Gleneagles Hospital, Hong Kong, special administrative region of China)

WHO was not involved in the delivery of any of these programmes, and featuring these stories does not constitute an endorsement of the organization or activities of the organizations featured.

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