Scientia potentia est—Why sharing knowledge about hand hygiene remains important

Summary

The theme of this year's World Hand Hygiene Day—which takes place on 5 May—is 'sharing knowledge'. In this blog, hub topic leader Julie Storr looks at the question of why it's still so important to share knowledge about hand hygiene. She highlights the power of sharing knowledge to save lives, the need to address research gaps and that hand hygiene should be integrated into all aspects of frontline care.  She also shares tools and resources that can be used to help train and equip frontline healthcare professionals.

Content

Knowledge is power, so the saying goes. This year, the World Health Organization (WHO) has made sharing knowledge the central theme for World Hand Hygiene Day (WHHD).

The 2024 campaign slogan poses a question: “Why is sharing knowledge about hand hygiene still so important?” We will come back to the answer in a moment. Before that, the WHO global strategy on Infection Prevention and Control (IPC) published last year reminds us that the spread of microbes that cause healthcare-associated infections (HAI) almost always takes place at the point of care, and because of this, infection prevention and control (IPC) needs to be understood and practised by everyone who provides services at the point of care. Specifically, it highlights the criticality of integrating IPC measures into patient pathways and clinical care delivery. Rather than seeing hand hygiene and IPC per se as stand-alone “things”, the emphasis is on integration and embedding. On this latter point, Patient Safety Learning's hub is a refreshingly diverse community of patient safety professionals, clinicians and patients who are not solely IPC-adjacent—sharing knowledge on hand hygiene and IPC beyond the usual suspects can help to support the aspiration of integration and embedding. 

Back to the campaign question. There are many possible answers, but this is the campaign response–it’s short and simple: “Because it helps stop the spread of harmful germs in healthcare.” Sharing knowledge is one way to support healthcare workers to become competent in their day to day IPC practices, a competency that sees hand hygiene and IPC integrated and embedded in daily routines. 

Global data presented on the campaign pages tells us that training and education emerge as some of the weakest areas of IPC in countries and healthcare facilities. This is reflected in disparities in IPC curricula at both pre- and postgraduate levels in medicine, nursing and midwifery. This affects the quality and effectiveness of IPC training and ultimately the knowledge of the health workforce.

Innovative and impactful training and education on IPC, including hand hygiene, is one way—the campaign suggests—of sharing knowledge effectively. This is an interesting angle and one that resonates with the ethos of Patient Safety Learning, who single out shared learning as one of the six evidence-based foundations of safer care. Sharing experiences, tools, resources and innovations is hard wired into the very structure of the hub as a mechanism to make healthcare safer. 

A recent editorial on WHHD highlighted available data on the global healthcare workforce “stock”, which is estimated to exceed 65 million people. Broken down, this comprises 29.1 million nurses, 12.7 million medical doctors, 3.7 million pharmacists, 2.5 million dentists, 2.2 million midwives and 14.9 million in additional occupations, including cleaners and healthcare waste workers but excluding management. These are staggeringly huge numbers, and yet in many countries nowhere near what is required for safe delivery of health care—but that would be another blog altogether. In the context of WHHD, what the data boils down to, the authors point out, is that each number represents a person requiring training and education in all matters necessary to deliver quality healthcare and maintain patient and health worker safety. This is where IPC comes into play. Active IPC programmes are a proven effective approach to protect patients, health workers and visitors to healthcare facilities by preventing avoidable infections. One element of an active IPC programme relates to hand hygiene improvement.

The facts and figures on hand hygiene and the burden of healthcare-associated infection continue to receive attention in the academic literature with scores of publications on the matter in the first few months of 2024 alone. In a nutshell, based on available evidence, hand hygiene performed by health workers at the right moments in healthcare remains a problem not yet solved, with compliance sub-optimal across many countries of the world. This jeopardises patient safety. WHHD is a global campaign designed to support local efforts to end this problem. Like all campaigns, it aims to maintain a profile on the issue, specifically on the importance of hand hygiene in health care by bringing people together in support of improvement across the globe. Each year, on or around 5 May, WHO renews its support to countries and health facilities and promotes approaches to improve hand hygiene practices in healthcare. Raising awareness is therefore a constant objective. 

A second objective for this year concerns the promotion of access to innovative hand hygiene and IPC training resources for health and care workers. Here are some of this year’s campaign assets:

• A 30 second video highlights important messages to encourage participation in WHHD 2024
• A 2-minute animated video telling Maria’s story of work in a clinic and the need for hand hygiene training
• Main campaign posters in blue and orange
• Bespoke posters targeting: the general public, IPC practitioners, health care workers and policy makers 
• Advocacy slide set outlining key activities individuals and organisations can undertake in support of WHHD 2024
• A wide range of campaign materials including posters, social media assets, web banners, a short video in social media vertical format
• Commentaries in academic journals 

A third objective of this year’s campaign is to strengthen learning approaches to enable the implementation of innovative and effective training. Training should empower health and care workers with enhanced knowledge, skills and behaviours to improve hand hygiene and IPC at the point of care. A brand-new WHO curriculum for in-service IPC training is being launched on 5 May 2024 in support of this.

And finally, something close to my heart—the launch of 'My 5 Moments: the Game'. On 5 May all five levels of 'My 5 Moments - The Game' will be available. This serious game is designed to encourage healthcare workers and students to creatively engage with the principles of hand hygiene. Set in the international alien hospital, players encounter a series of challenges to test their knowledge of the WHO My 5 Moments for Hand Hygiene, embedded within compassionate clinical care delivery. The game is an innovative, free resource, developed collaboratively by the WHO IPC Hub, the WHO Academy, Marist University and Serious Games Interactive, to support healthcare workers in translating the principles of hand hygiene into their real-life encounters with patients. Find out more in this short video preview of the game.

WHHD 2024 has a very noble aspiration. Sharing knowledge and information on hand hygiene and IPC is necessary for patient safety. Looking to what happens after 5 May 2024, I also agree with colleagues at Patient Safety Learning who call for a more systematic approach to sharing knowledge and information about which patient safety initiatives and solutions work. That’s why the recent WHO research agenda for hand hygiene in health care 2023–2030 is important. There remain many research gaps that need to be addressed in order to improve understanding of the factors influencing hand hygiene behaviour and to strengthen appropriate interventions. 

The saying scientia potentia est—knowledge is power—was originally attributed to Hobbes and reportedly further expanded on by Thomas Jefferson, who proclaimed that knowledge also provides safety and happiness. World Hand Hygiene Day, like all healthcare-related campaigns, is essentially concerned with alleviating suffering and maintaining health and wellbeing. A knowledgeable, empowered workforce, sharing knowledge and sharing learning are at the heart of patient safety. 5 May helps to make sure this important matter remains on the agenda.

To find out more join the WHO IPC Global Webinar: World Hand Hygiene Day 2024 - why is sharing knowledge about hand hygiene still so important? on 6 May 2024, 2:00-3:30 pm CET.

About the Author

Julie Storr is Founder and CEO at KS Healthcare Consulting, Past President at the Infection Prevention Society of the UK and Ireland and a global health consultant. You can follow her on X @julesstorr and @safesafersafest.