Kilpatrick, C.

Pittet, D.

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EDITORIALWHO SAVE LIVES: Clean Your Hands global annual campaign.A call for action: 5 May 2011C. Kilpatrick • D. PittetReceived: 7 March 2011 / Accepted: 21 March 2011 / Published online: 12 April 2011 Springer-Verlag 2011The World Health Organization (WHO) SAVE LIVES:Clean Your Hands was launched in 2009. This global,annual campaign was developed as an extension of theWHO Clean Care is Safer Care programme. It is targeted athealthcare facilities and has the aim of ‘Bringing peopletogether to improve and sustain hand hygiene’ every 5May.WHO’s motivation has been, and continues to be, inresponse to the concerns over the global burden of dis-ease due to healthcare-associated infections (HAI), bothin developed and developing countries [1]. Recently-published data collated by WHO highlight that, whenknown, HAI rates are, indeed, markedly higher indeveloping countries than developed countries, with upto 19% of patients estimated to acquire an HAI hospital-wide. Surgical site infections are known to be the mostfrequent in these countries and can occur at rates of upto 25% of all surgical procedures. For ventilator-associ-ated pneumonia (VAP) and neonatal infections, the ratesare equally as alarming. VAP occurs up to 17 timesmore frequently in developing than in developed coun-tries, with an excess mortality rate as high as 27%.Neonatal infections are three to 20 times higher and areresponsible for 4–56% of all deaths in the neonatalperiod. The costs to healthcare systems are also wellrecognised, particularly in the developed world [2, 3].In its first 2 years, WHO SAVE LIVES: Clean YourHands has, on each 5 May, galvanised unprecedentedaction, including the receipt of online written commitmentfrom 5,000 healthcare facilities in 2009, subsequentlytotalling over 11,000 in 2010, well exceeding the 10,000expectation (see Fig. 1). This corroborates the understand-ing that hand hygiene practices are seen at the core ofaddressing HAI, but can still be improved [4].Actions taken in both 2009 and 2010 demonstrate howeager healthcare workers are to ensure real change is madeat the point of care to enhance patient safety and reduceHAI. To begin the move from demonstrating commitmentto taking action, in 2010, a global survey of hand hygienecompliance with Moment 1 of the WHO ‘My 5 Momentsfor Hand Hygiene’, ‘Before touching a patient’, wasannounced by WHO, the first of its kind. Approximatelyone-third of all healthcare facilities that had already reg-istered for SAVE LIVES: Clean Your Hands took part inthis survey and the results have been presented as per thesix WHO regions, as well as individual participantsreceiving feedback on their own data [5].To build momentum and maintain a global profile on theneed for clean hands in healthcare, for 5 May 2011, the aimis clear; ‘move from commitment to sustained action onhand hygiene improvement’.The WHO’s call is ‘Where do YOU stand on handhygiene?’ and the WHO Hand Hygiene Self-AssessmentFramework is being promoted to help the understanding ofthis. All registered healthcare facilities around the globeFor full information on WHO SAVE LIVES: Clean Your Hands, visithttp://www.who.int/gpsc/5may.C. Kilpatrick  D. PittetClean Care is Safer Care World Health Organization PatientSafety Programme, Geneva, SwitzerlandD. Pittet (&)Infection Control Programme and WHO Collaborating Centreon Patient Safety, University of Geneva Hospitals and Facultyof Medicine, 4 Rue Gabrielle Perret-Gentil,1211 Geneva 14, Switzerlande-mail: didier.pittet@hcuge.chInfection (2011) 39:93–95DOI 10.1007/s15010-011-0106-8are now being welcomed to participate. The benefits ofusing the Hand Hygiene Self-Assessment Framework inthis regard are clear and are presented on the WHO webpages, where the tool can be downloaded http://www.who.int/gpsc/5may (see the Appendix).Everyone has a role to play in SAVE LIVES: CleanYour Hands and the WHO’s role is one of encouragingwidespread action and helping maintain the global profile(see Table 1).This fledgling campaign has given insight into howthose with responsibility for ensuring patient safetythrough clean hands around the globe react to a WHOcall for action and builds on the information available tothe WHO through the Clean Care is Safer Care Pro-gramme. Launched in 2005, the WHO First GlobalPatient Safety Challenge: Clean Care is Safer Care aims,overall, to address the global problem of HAI. The mainoutput of this WHO patient safety programme of workFig. 1 WHO SAVE LIVES: Clean Your Hands registrations—February 2011: 12,394 registered healthcare facilities from 146 countriescorresponding to approximately 7 million healthcare staff and 3 million patient bedsTable 1 Success of SAVE LIVES: Clean Your Hands—the roles of all involvedHealthcare facilities Advocates at organisational, national andregional levelsWHOCommit: register for SAVE LIVES: CleanYour Hands (if not already done so)Track progress: use the WHO Hand HygieneSelf-Assessment FrameworkPlan actions: address the components of theWHO multimodal improvement strategyand plan the reuse of the frameworkCommunicate: inform the WHO on using theHand Hygiene Self-Assessment Frameworkand plan and share other 5 May 2011‘promotional’ activities by presentinginformation on local web pagesPromote: use of the WHO Framework (andWHO Hand Hygiene Self-AssessmentFramework tools) for improved andsustained hand hygiene; SAVE LIVES:Clean Your Hands commitment throughregistering with the WHO; 5 May 2011‘promotional’ activities, with features onlocal web pagesEncourage: through regular communications,including a monthly newsletter; availability oftools; monitoring of Hand Hygiene Self-Assessment Framework use; gathering of asample of completed self-assessments;announcing registration numbers; issuing newinformation on the global burden of HAI;coordinating a special global teleclass on 5May94 C. Kilpatrick, D. Pittethas been the WHO Guidelines on Hand Hygiene inHealth Care [4] and has, additionally, included the WHOHand Hygiene Improvement Toolkit that supportsimplementation of the recommended WHO multimodalimprovement strategy. This model was developed withina clinical setting and further validated to ensure appli-cability to all healthcare settings worldwide, irrespectiveof resources, through testing in eight pilot sites [4], whilewider global activities to allow for widespread awarenessraising and cascade training on the implementation of theimprovement strategy were additionally undertaken.Clean Care is Safer Care aims to continue to encouragecountries as well as facilities to focus on sustaining handhygiene improvement, to ensure that hand hygiene stays asa priority on national healthcare agendas. Besides thecommitment seen through SAVE LIVES: Clean YourHands, enthusiasm at the country level has been evidentand, indeed, continues to grow. At the end of 2010, 124Ministries of Health had signed a pledge to address HAIs,which represents almost 90% of the world’s population,and 41 countries/areas had reported the existence of formalhand hygiene campaigns. The WHO has also formed theWHO CleanHandsNet as a network to facilitate progress insuch countries, as well as to support the sharing of suc-cesses and strategies.To truly protect our patients, it takes leadership, com-mitment and a range of actions, from all levels. The WHO’sefforts are internationally focused and have demonstratedthat the support being provided by this programme to countrycampaigns in particular is relevant and well received [6].Along with countries and facilities, this ‘top down and bot-tom up’ approach should help bring true ownership tohealthcare workers in relation to the prevention of microor-ganism transmission at the point of patient care and, subse-quently, long-term patient safety improvement.The WHO’s call for action for 5 May 2011, and, indeed,every year, is an important step in the global recognitionthat hand hygiene practices must still be improved andsubsequently sustained.Conflict of interest The authors have declared that no competinginterests exist.AppendixReferences1. Pittet D, Donaldson L. Clean Care is Safer Care: a worldwidepriority. Lancet. 2005;366:1246–7.2. Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W,Attar H, Donaldson L, Pittet D. Burden of endemic health-care-associated infection in developing countries: systematic reviewand meta-analysis. Lancet. 2011;377:228–41.3. The burden of health care-associated infection worldwide: asummary. Geneva: World Health Organization, 2010. Availableonline at: http://www.who.int/gpsc/country_work/summary_20100430_en.pdf.4. Guidelines on Hand Hygiene in Health Care. Geneva: WorldHealth Organization, 2009.5. Hand hygiene moment 1—global observation survey: summaryreport. Geneva: World Health Organization, 2010. Availableonline at: http://www.who.int/gpsc/5may/news/ps_moment1_results_2010_en.pdf.6. Mathai E, Allegranzi B, Kilpatrick C, Bagheri Nejad S, GraafmansW, Pittet D. Promoting hand hygiene in healthcare throughnational/subnational campaigns. J Hosp Infect. 2011;77:294–8.doi:10.1016/j.jhin.2010.10.012.Benefits of being part of the WHO’s call for 5 May 2011 tounderstand where you stand on hand hygiene through use of theHand Hygiene Self-Assessment FrameworkSystematically assesses the level of progress on hand hygieneimprovement in the areas of infrastructure, resources, commitmentand achievementsIdentifies the issues requiring particular attention and improvementFacilitates the development of an action plan for facilities’ handhygiene improvement programmesDirects you to other WHO Hand Hygiene Improvement Tools tosupport actionsAllows for structured discussions on results and for thedocumentation of progress over timeSupports the clear reporting of results, against an action plan, to thedirectorate of a healthcare facility—allowing for ongoing high-levelprogress reviewsWHO SAVE LIVES: Clean Your Hands global annual campaign 95

WHO SAVE LIVES: Clean Your Hands global annual campaign. A call for action: 5 May 2011

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WHO SAVE LIVES: Clean Your Hands global annual campaign. A call for action: 5 May 2011

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