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Disclosures: Peters does not report any relevant financial information. Please see the study for relevant financial information from all other authors.

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Globally, many healthcare facilities lack good environmental hygiene practices, a survey has found.

“After seeing the state of healthcare environmental hygiene (HEH) internationally, our team wanted to come up with a tool that could help healthcare facilities improve, regardless of their level of health. resources”, Alexandra Peters, PhD, chief scientist of the Clean Hospitals Infection Control Program and the WHO Collaborating Center on Patient Safety, Healio told Healio. “The pilot study was the first step in the development of this tool.”

Hand washing
A pilot survey has shown that many healthcare facilities around the world lack environmental health care practices. Source: Adobe Stock.

Alexandra Peters

The survey was developed by a panel of experts and based on the WHO Multimodal Hand Hygiene Improvement Strategy, which includes five objectives, including ensuring that the necessary infrastructure is in place to enabling health workers to perform hand hygiene, providing regular training, monitoring hand hygiene practices and infrastructure, and providing feedback on performance and results.

The main objective of the survey was to test a preliminary version of an HTL self-assessment framework. Researchers have used it to collect data on HTL programs around the world. They sent the survey to 743 health care facilities (HCFs) of all World Bank income levels.

A total of 51 health facilities from 35 countries participated, of which 98% reported that ESH was lacking in some or all of the five components of the WHO strategy.

In addition, 71% of respondents felt that their establishment gave enough importance to HTL and 47% felt that the budget allocated to cleaning and disinfection was adequate. Among other results, 67% of health facilities said the necessary HTL products and supplies were always available, while 27% said they were sometimes available, and 6% said they were never or rarely available. available. Of the 90% of healthcare facilities that said HTL equipment and supplies were available, 16% still could not perform adequate sterilization because the equipment was not in good working order.

Other survey results showed that just over 50% of healthcare facilities said their protocols were based on best practices and updated regularly and only 22% of healthcare facilities provided or required – if staff were outsourced – full formal HTL training upon hiring. Additionally, 28% did not provide or require any formal training.

Peters said data shows HEH programs are “shockingly lacking around the world,” even in wealthy countries.

“HEH is not only a technical problem but also a human one,” she said. “Cleaning staff have a very important role to play in patient safety. Institutions must train and support the human components as well as the technical components. »


APIC. A new survey illustrates the challenges associated with healthcare environmental hygiene in facilities around the world. Accessed June 2, 2022.

WHO. A guide to implementing the WHO Multimodal Hand Hygiene Improvement Strategy. Accessed June 2, 2022.