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Organizational culture issues, key strategies
It is important to investigate the reasons for nonadherence to hand hygiene guidelines before deciding on one or more improvement strategies, according to a new report by The Joint Commission and its partners. It also is useful to examine the organizational context of health care delivery, which may facilitate or inhibit adherence. Such organizational factors include:
The facility's physical capacity for making products available.
The presence of written hand hygiene policies and procedures.
The active involvement of leadership "from the top down."
The presence of role models.
The degree of accountability for nonadherent staff.
The presence of a culture of safety.
The active involvement of staff in improvement efforts.
The awareness and involvement of patients and families.
Staff hand hygiene practices can be improved through efforts such as:
structured approaches to performance improvement.
The following organizations, which collaborated with The Joint Commission on this monograph, are good resource for information on improving the measurement of hand hygiene performance:
The Association for Professionals in Infection Control and Epidemiology Inc. (APIC) (www.apic.org).
The Centers for Disease Control and Prevention (CDC) (www.cdc.gov).
The Institute for Healthcare Improvement (IHI) (www.ihi.org).
The National Foundation for Infectious Diseases (NFID) (www.nfid.org).
The Society for Healthcare Epidemiology of America (SHEA) (www.shea-online.org).
The World Health Organization (WHO) (www.who.int/gpsc/en/index.html).
(Editor's note: The Joint Commission report: "Measuring Hand Hygiene Adherence: Overcoming the Challenges" is available on the commission's web site at: www.jointcommission.org.)