Clean Care is Safer Care

Background to Clean Care is Safer Care

WHO Global Patient Safety Challenges have represented calls from around the world on specific patient safety issues and have been reflected in global campaigns which bring together expertise and evidence to raise awareness and to catalyze political and professional commitment on these important patient safety aspects. They also generate knowledge, recommendations and actions to improve the safety of patients receiving care globally.

The focus and objectives of Clean Care is Safer Care

The first of these Challenges, Clean Care is Safer Care, was targeted at the important aspect of reducing health care-associated infections (HCAIs). HCAI is the most frequent harmful event in health-care delivery and occurs worldwide in both developed and developing countries. Hundreds of millions of patients are affected each year, leading to significant mortality and financial losses for health systems.

The initial focus of Clean Care is Safer Care, launched in October 2005, was to promote best hand hygiene practices globally, at all levels of health care, as a first step in ensuring high standards of infection control and patient safety. Hand hygiene, a very simple action to ensure hands are free of germ, is well accepted to be the primary measure to reduce HCAI, enhancing patient safety. The vision of Clean Care is Safer Care is to make infection prevention and control a priority in health care everywhere, with clean hands as the basis, and for this reason an annual campaign to maintain a global profile; SAVE LIVES: Clean Your Hands, was launched in 2009.

Awareness raising on the burden of HCAI and the importance of hand hygiene, catalyzing political and stakeholders' commitment to reduce HCAI, developing technical guidance and recommendations and supporting actions in Member States have been the main objectives of Clean Care is Safer Care. This has included coordinating the sharing of information about activities among existing country/area hand hygiene campaigns, through an informal but well-established network called CleanHandsNet.

Key accomplishments of Clean Care is Safer Care

  • More than two thirds of Ministries of Health from Member States having signed formal statements pledging their commitment to take action to reduce HCAI at the country level, in particular through hand hygiene improvement.
  • WHO Guidelines on Hand Hygiene in Health Care; the first international guidelines on this topic, providing technical recommendations to health-care facilities worldwide.
  • The WHO "My Five Moments for Hand Hygiene"; a user-friendly, innovative way to understand, monitor and practice hand hygiene action at the point of patient care.
  • A Multimodal Improvement Strategy based on the recommendations in the Guidelines; field tested in a wide range of different health-care settings for feasibility, adaptability and success, subsequently demonstrated both in high and low-/middle-income countries.
  • A package of 32 implementation tools to support the Strategy (thus far in three official WHO languages) including posters, templates, instructions.
  • WHO Hand Hygiene Self-Assessment Framework, to help track progress with hand hygiene sustainability.
  • WHO Moment 1 'before touching a patient' global observation survey report (2010).
  • 64 scientific publications and 49 abstracts at international conferences.
  • Engagement of leading infection prevention and control societies and institutions.
  • Cascade training on infection control to build capacity globally and at country level and establishment of regular virtual training sessions.
  • Sign-up from well over 15 000 health-care facilities in support of SAVE LIVES: Clean Your Hands; the overall approach to hand hygiene improvement provided by WHO has been extremely successful and widely adopted in health-care settings worldwide.
  • A Guide to the Application of the WHO Multimodal Hand Hygiene Improvement Strategy and the "My Five Moments For Hand Hygiene" approach in Outpatient and Home-based Care and Long-term Care Facilities, accompanied by adapted tools.
  • WHO Hand Hygiene Self-Assessment Framework global survey report (2012)

Moving forward

WHO Clean Care is Safer Care will continue to provide leadership and advocate to support a reduction of the global endemic burden of health care-associated infections, including:

  • Promotion of activities for hand hygiene improvement and sustainability, primarily through the SAVE LIVES: Clean Your Hands campaign, moving countries from commitment to true action at the point of care.
  • Coordination of WHO CleanHandsNet.
  • Updating the WHO Guidelines on Hand Hygiene in Health Care and including new information on our web pages.
  • Estimating the burden of endemic HCAI worldwide, in particular by evaluating the magnitude of the problem in settings with limited resources where available data are very scarce but where HCAI is much more frequent than in developed countries.
  • Identifying specific new solutions to be developed and promoted in addition to hand hygiene. Special focus is being put on the prevention of specific infection types, in particular surgical site and bloodstream infections, in collaboration with other WHO programmes and global experts.
  • Identification of feasible infection control strategies to be adapted for settings with limited resources.
  • Supporting knowledge transfer of key infection control principles through a range of mechanisms.
  • Identifying gaps in the infection control evidence and new threats, working alongside other global experts.

Team members

Professor Didier Pittet, an internationally renowned expert in the field of infection prevention and control, is the external lead of Clean Care is Safer Care. He provides leadership and technical input through the activities of the WHO Collaborating Centre on Patient Safety at the University of Geneva Hospitals, supported by a core team.

A small team is the core of Clean Care is Safer Care and exists within the WHO Patient Safety Programme at WHO headquarters in Geneva to facilitate delivery of the above plans.

In addition, a core group of international experts significantly contribute to the work of Clean Care is Safer Care, especially regarding the preparation of the WHO Guidelines on Hand Hygiene in Health Care and the development of hand hygiene tools. The Programme also works in close collaboration with leading international and national organizations in the field of infection control and infectious diseases.