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© World Health Organization 2009. All rights reserved.
Slide 1
Data Summary Report Framework
Revised October 2009
Slide 2
User instructions (1)
■ This presentation is intended to give some examples of how best to present the results of the surveys performed during the evaluation phases of the implementation of the hand hygiene improvement strategy
■ The presented results can refer to the entire facility (hospital-wide) or can be related to the unit, service or ward where the data were collected
■ These results can be reported to staff, to explain the current practices, knowledge and perception of hand hygiene in their health-care setting and to highlight the aspects that need improvement, or to compare baseline with follow-up data to show possible improvements resulting from the range of efforts made
Slide 3
User instructions (2)
■ The local data must be inserted in the template presentation
■ The template includes reporting of the knowledge survey, the perception surveys (for health-care workers and senior managers) and the hand hygiene observation survey
■ Correct answers where provided by WHO are written in this colour
■ Slides 84 to 88 are examples of comparisons between baseline and follow-up measurements
■ Data for the slides can be generated using data-entry and data-analysis in Epi InfoTM (available at: http://www.who.int/gpsc/5may/tools/evaluation_feedback/en/index.html)
© World Health Organization 2009. All rights reserved.
Slide 4
Results of the Hand Hygiene Knowledge Questionnaire for Health-Care Workers
(Name of facility)
Slide 5
Methods
■ Distribution of the WHO “Hand Hygiene Knowledge Questionnaire for Health-Care Workers” to health-care workers in identified clinical settings
■ Data entry and analysis using the Data Entry Analysis Tools
■ Use of this presentation to provide feedback
Slide 6
Q8–9. Participants’ characteristics
■ Total number of participants:
■ Gender:Female: (%)Male: (%)
■ Age:Median: + interquartile rangeMean: ± standard deviation (SD)(Median and range are preferred as they represent
centrality and spread of not normally distributed data)
Slide 7
Q 10. Profession
Profession Number (%)
Nurse
Auxiliary nurse
Midwife
Medical Doctor
Resident
Technician
Therapist
Nurse student
Medical student
Other
Slide 8
Q11. Department
Department Number (%)
Internal medicine
Surgery
Intensive care unit
Mixed medical/surgical
Emergency unit
Obstetrics
Paediatrics
Long-term/rehabilitation
Outpatient clinic
Other
Slide 9
Q12–13. Hand hygiene training and availability of alcohol-based handrub
■ Formal training in hand hygiene: number (%)
■ Do you routinely use an alcohol-based handrub for hand hygiene?: number (%)
Slide 10
Q14. Which of the following is the main route of cross-transmission of potentially harmful germs between patients in a health-care facility?
■ HCWs’ hands when not clean: number (%)
■ Air circulating in the hospital: number (%)
■ Patients’ exposure to colonised surfaces: number (%)
■ Sharing non-invasive objects (i.e. stethoscopes, pressure cuffs, etc.) between patients: number (%)
Slide 11
Q15. What is the most frequent source of germs responsible for health care-associated infections?
■ The hospital’s water system: number (%)
■ The hospital air: number (%)
■ Germs already present on or within the patient: number (%)
■ The hospital environment (surfaces): number (%)
Slide 12
Q16. Which of the following hand hygiene actions prevents transmission of germs to the patient?
Action Yes No
Before touching a patient (%) (%)
Immediately after a risk of body fluid exposure
(%) (%)
Immediately before a clean/aseptic procedure
(%) (%)
After exposure to the immediate surroundings of a patient
(%) (%)
Slide 13
Q17. Which of the following hand hygiene actions prevents transmission of germs to the health-care worker?
Action Yes No
After touching a patient (%) (%)
Immediately after a risk of body fluid exposure
(%) (%)
Immediately before a clean/aseptic procedure
(%) (%)
After exposure to the immediate surroundings of a patient
(%) (%)
Slide 14
Q18. Which of the following statements on alcohol-based handrub and hand washing with soap and water are true?
Statement True False
Handrubbing is more rapid for hand cleansing than handwashing
(%) (%)
Handrubbing causes skin dryness more than handwashing
(%) (%)
Handrubbing is more effective against germs than handwashing
(%) (%)
Handwashing and handrubbing are recommended to be performed in sequence
(%) (%)
Slide 15
Q19. What is the minimal time needed for alcohol-based handrub to kill most germs on your hands?
■ 20 seconds: (%)
■ 3 seconds: (%)
■ 1 minute: (%)
■ 10 seconds: (%)
Slide 16
Q20. Which type of hand hygiene method is required in the following situations?
Situation Rubbing Washing None
Before palpation of the abdomen (%) (%) (%)
Before giving an injection (%) (%) (%)
After emptying a bedpan (%) (%) (%)
After removing examination gloves (%) (%) (%)
After making a patient's bed (%) (%) (%)
After visible exposure to blood (%) (%) (%)
Slide 17
Percentage of correct answers to question 20
0
20
40
60
80
100
Beforepalp
Beforeinjection
Afterbedpan
Aftergloves
Afterpatient's
bed
Afterblood
Situations requiring hand hygiene
%
Slide 18
Q21. Which of the following should be avoided, as associated with a likelihood of colonisation of hand with harmful germs?
Likelihood of hand colonization Yes No
Wearing jewellery (%) (%)
Damaged skin (%) (%)
Artificial fingernails (%) (%)
Regular use of a hand cream (%) (%)
© World Health Organization 2009. All rights reserved.
Slide 19
Conclusions and recommended actions:
To be inserted locally.
© World Health Organization 2009. All rights reserved.
Slide 20
Results of the Perception Survey for Health-Care Workers
(Name of facility)
Slide 21
Methods
■ Distribution of the WHO “Perception Survey for Health-Care Workers" to health-care workers in identified clinical settings
■ Data entry and analysis using the Data Entry Analysis Tools
■ Use of this presentation to provide feedback
Slide 22
Q8-9. Participants’ characteristics
■ Total number of participants:
■ Gender:Female: (%)Male: (%)
■ Age:Median: + interquartile rangeMean: ± standard deviation (SD)(Median and range are preferred as they represent
centrality and spread of not normally distributed data)
Slide 23
Q 10. Profession
Profession Number (%)
Nurse
Auxiliary nurse
Midwife
Medical Doctor
Resident
Technician
Therapist
Nurse student
Medical student
Other
Slide 24
Q11. Department
Department Number (%)
Internal medicine
Surgery
Intensive care unit
Mixed medical/surgical
Emergency unit
Obstetrics
Paediatrics
Long-term/rehabilitation
Outpatient clinic
Other
Slide 25
Q12–13. Hand hygiene training and availability of alcohol-based handrub
■ Formal training in hand hygiene: number (%)
■ Do you routinely use an alcohol-based handrub for hand hygiene?: number (%)
Slide 26
Q14. In your opinion, what is the average rcentage of hospitalised patients who will develop a health care-associated infection (HCAI)?
0-10 11-20 21-3031-40
41-50
51-60
61-70
71-80
81-90
91-100
0
20
40
60
80
100
%
Percentage of hospitalized patients developing a HCAI
Slide 27
Q15. In general, what is the impact of a health care-associated infection on a patient's clinical outcome?
■ Very low: number (%)
■ Low: number (%)
■ High: number (%)
■ Very high: number (%)
Slide 28
Q16. What is the effectiveness of hand hygiene in preventing health care-associated infection?
■ Very low: number (%)
■ Low: number (%)
■ High: number (%)
■ Very high: number (%)
Slide 29
Q17. Among all patient safety issues, how important is hand hygiene at your institution?
■ Low priority: (%)
■ Moderate priority: (%)
■ High priority: (%)
■ Very high priority: (%)
Slide 30
Q18. On average, in what percentage of situations requiring hand hygiene do health-care workers in your hospital actually perform hand hygiene?
0-10
11-20
21-30
31-4041-50 51-60
61-70
71-80 81-90
91-100
0
20
40
60
80
100
%
percentage of situations health-care workers perform hand hygiene when required
© World Health Organization 2009. All rights reserved.
Slide 31
Q19.
In your opinion, how effective would the following actions be to improve hand hygiene permanently in your institution?
Slide 32
Q19.a. Leaders and senior managers at your institution support and openly promote hand hygiene
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 33
Q19.b. The health-care facility makes alcohol-based handrub always available at each point of care
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 34
Q19.c. Hand hygiene posters are displayed at point of care as reminders
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 35
Q19.d. Each health-care worker receives education on hand hygiene
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 36
Q19.e. Clear and simple instructions for hand hygiene are made visible for every health-care worker
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 37
Q19.f. Health-care workers regularly receive feedback on their hand hygiene performance
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 38
Q19.g. You always perform hand hygiene as recommended (being a good example for your colleagues)
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 39
Q19.h. Patients are invited to remind health-care workers to perform hand hygiene
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 40
Q20. What importance does the head of your department attach to the fact that you perform optimal hand hygiene?
0
20
40
60
80
100
Noimportance
2 3 4 5 6 Very highimportance
%
Slide 41
Q21. What importance do your colleagues attach to the fact that you perform optimal hand hygiene?
0
20
40
60
80
100
Noimportance
2 3 4 5 6 Very highimportance
%
Slide 42
Q22.What importance do patients attach to the fact that you perform optimal hand hygiene?
0
20
40
60
80
100
Noimportance
2 3 4 5 6 Very highimportance
%
Slide 43
Q23. How do you consider the effort required by you to perform good hand hygiene when caring for patients?
0
20
40
60
80
100
No effort 2 3 4 5 6 A bigeffort
%
Slide 44
Q24. On average, in what percentage of situations requiring hand hygiene do you actually perform hand hygiene, either by handrubbing or handwashing?
0-1011-20 21-30 31-40
41-50
51-60
61-70
71-80
81-9091-100
0
20
40
60
80
100
%
Percentage of situations where you perform hand hygiene when required
© World Health Organization 2009. All rights reserved.
Slide 45
Conclusions and recommended actions:
To be inserted locally.
© World Health Organization 2009. All rights reserved.
Slide 46
Results of the Perception Survey for Senior Managers
(Name of facility)
Slide 47
Methods
■ Distribution of the WHO “Perception Survey for Health-Care Workers" to health-care workers in identified clinical settings
■ Data entry and analysis using the Data Entry Analysis Tools
■ Use of this presentation to provide feedback
Slide 48
Q5. Participants’ characteristics
■ Total number of participants:
■ Gender:Female: (%)Male: (%)
Slide 49
Q6–8. Participants’ characteristics
■ Time spent in current position:
■ Time spent in present institution:
■ Current position(s):Director: (%)Head nurse: (%)Head physician: (%)Hospital administrator: (%)
Slide 50
Q9–10. Hand hygiene campaign and availability of alcohol-based handrub
■ Have you had any previous experience of a hand hygiene campaign: number (%)
■ Is an alcohol-based formulation available for hand hygiene at your facility: number (%)
Slide 51
Q11. In your opinion, what is the average percentage of hospitalised patients who will develop a health care-associated infection?
0 5 10 1520
25
30
35
40
45 5060
0
20
40
60
80
100
%
Percentage of hospitalized patients developing a HCAI
Slide 52
Q12. In general, what is the impact of a health care-associated infection on patient's clinical outcome?
■ Very low: (%)
■ Low: (%)
■ High: (%)
■ Very high: (%)
Slide 53
Q13. In general, what is the impact of a health care-associated infection on the facility expenditures?
■ Very low: (%)
■ Low: (%)
■ High: (%)
■ Very high: (%)
Slide 54
Q14. What is the effectiveness of hand hygiene in
preventing health care-associated infection?
■ Very low: (%)
■ Low: (%)
■ High: (%)
■ Very high: (%)
Slide 55
Q15. Among all patient safety issues, how important is hand hygiene within your management priorities at your institution?
■ Low priority: (%)
■ Moderate priority: (%)
■ High priority: (%)
■ Very high priority: (%)
Slide 56
Q16. On average, in what percentage of situations requiring hand hygiene do health-care workers in your facility actually perform hand hygiene?
0-10
11-20
21-30
31-4041-50 51-60
61-70
71-80 81-90
91-100
0
20
40
60
80
100
%
Percentage of situations where health-care workers perform hand hygiene when required
Slide 57
Q17. Are senior nurses and doctors good examples for the promotion of hand hygiene at your facility?
0
20
40
60
80
100
Not at all 2 3 4 5 6 Very good
%
Slide 58
Q18. Is it common practice to inform patients about the importance of optimal hand hygiene during health-care delivery at your facility?
■ Yes: number (%)
■ No: number (%)
Slide 59
Q19. How do you consider the effort required by health-care workers to perform good hand hygiene when caring for patients at your facility?
0
20
40
60
80
100
No effort 2 3 4 5 6 A bigeffort
%
Slide 60
Q20. How do health-care workers perceive your request to perform optimal hand hygiene during patient care at your facility?
0
20
40
60
80
100
Of littleimportance
3 5 Veryimportant
%
© World Health Organization 2009. All rights reserved.
Slide 61
Q21. In your opinion, how effective would the following actions be to increase hand hygiene permanently in your facility?
Slide 62
Q21.a. Leaders and senior executive managers (you) at your facility support and openly promote hand hygiene
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 63
Q21.b. The health-care facility makes alcohol-based handrub available at each point of care
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 64
Q21.c. Hand hygiene posters are displayed at point of care as reminders
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 65
Q21.d. Each health-care worker receives education on hand hygiene
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 66
Q21.e. Clear and simple instructions for hand hygiene are made visible for every health-care worker
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 67
Q21.f. Health-care workers regularly receive the results of their hand hygiene performance
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 68
Q21.g. Senior nurses and doctors perform hand hygiene perfectly (being a good example…)
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Slide 69
Q21.h. Patients are invited to remind health-care
workers to perform hand hygiene
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
© World Health Organization 2009. All rights reserved.
Slide 70
Conclusions and recommended actions
To be inserted locally.
© World Health Organization 2009. All rights reserved.
Slide 71
Results of the Hand Hygiene Observation Survey
(Name of facility)
Slide 72
Methodology of observation
■ Direct observation of hand hygiene practices in identified clinical settings
■ One (or two) trained and validated observer(s) observe health-care workers’ hand hygiene practices at the point-of-care
■ Professional categories to be observed: nurse, midwife, auxiliary nurse, medical doctor, therapist, technician, any other health-related professional involved in patient care
■ The observer conducts observations openly, but the identities of the health-care workers are kept confidential
■ Each observation session lasts approx 20 min
■ Compliance against WHO’s “5 Moments for Hand Hygiene” (indications) is detected: before patient contact, before an aseptic task, after body fluid exposure risk, after patient contact and after contact with patient surroundings
■ Compliance is recorded against the opportunities for hand hygiene that occurred
■ Handrubbing with alcohol-based handrub and handwashing practices are also recorded
Slide 73
Methods for data collation and presentation
■ Data entering and analysis using the Data Entry Analysis Tool
■ Calculation of compliance:
■ Use of this presentation to provide feedback
Hand hygiene actions performed
Hand hygiene actions required(hand hygiene opportunities)
Compliance =
Slide 74
Observations: Results
■ name of facility
■ department
■ x opportunities
■ x sessions
■ x hours/mins
■ compliance x%
Slide 75
Profession: Number of opportunities
104
67
25
30
Nurse/midwifeMedical doctorAuxiliaryOther
Slide 76
Profession: Compliance
67
4540
35
0
20
40
60
80
100
Nurses/midwife Medical doctor Auxiliary nurses Others
%
Slide 77
Indications: Number of opportunities
15
25
35
15
10
Before touching a patient
Before clean/asepticprocedureAfter body fluids
After touching a patient
After patient surroundings
Slide 78
Indications: Compliance
31
74
5754
73
0
20
40
60
80
100
Before patient Before asepticprocedure
After body fluid After patient After patientsurroundings
%
Slide 79
Departments: Number of opportunities
213
312
204230
286
254
Obstetrics
ICU
Long-term
Medicine
Surgery
Pediatrics
Slide 80
Departments: Compliance
67%
56%
51%
0% 20% 40% 60% 80% 100%
ICU
Medicine
Surgery
Slide 81
Handrubbing vs. handwashing
0%
20%
40%
60%
80%
100%
Surgery Medicine ICU Total
Handwashing
Handrubbing
© World Health Organization 2009. All rights reserved.
Slide 82
Conclusions and recommendation actions:
To be inserted locally.
© World Health Organization 2009. All rights reserved.
Slide 83
The following 5 slides are examples of how to present results from the evaluation surveys at different moments in time as indicated by the variable Period Number (generated by Epi Info).
This applies to the comparison of baseline and follow-up measurements produced by using the surveys multiple times.
Slide 84
Longitudinal measurement: date range and availability of completed surveys
Period number
Date range
Date_1 – Date _2 Number of surveys
X
Y
Z
Total:
Slide 85
Q8-9. – of knowledge survey ("Characteristics of respondents"): comparison of two periods
Variable
Period X
(Date range)
Period Y
(Date range)
Period Z
(Date range)
Age
(median, quartiles)
Gender
Profession
(in categories)
Ward
Etc.
Slide 86
Q20. - of the knowledge survey (Percentage of correct answers to question – "Which type of hand hygiene method is required in the following situations?"): comparison of two periods (period X and period Y)
0
20
40
60
80
100
Before palp Before injection After bedpan After gloves After patient'sbed
After blood
Situations requiring hand hygiene
%
Period X Period Y
Slide 87
Q19.a. - of the perception survey ("Leaders and senior managers at your institution support and openly promote hand hygiene"): comparison of two periods
0
20
40
60
80
100
Noteffective
2 3 4 5 6 Veryeffective
%
Period X Period Y
Slide 88
Indications - Compliance: comparison of two periods (X, date-range 1; Y, date-range 2)
3133
7478
5760
54
7773
63
0
20
40
60
80
100
Before patient Beforeaseptic
procedure
After bodyfluid
After patient After patientsurroundings
%
Period X Period Y
© World Health Organization 2009. All rights reserved.
Slide 89
Find out more about why all of these elements are important for improving and sustaining hand hygiene in the WHO Guidelines on Hand Hygiene in Health Care (2009) and in other implementation toolswww.who.int/gpsc
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