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WHO global research agenda for hand hygiene improvement in health care: a Delphi consensus study

Published online by Cambridge University Press:  20 March 2025

Benedetta Allegranzi ,
Ermira Tartari Open the ORCID record for Ermira Tartari [Opens in a new window] ,
Claire Kilpatrick Open the ORCID record for Claire Kilpatrick [Opens in a new window] ,
Julie Storr Open the ORCID record for Julie Storr [Opens in a new window] ,
Nita Bellare Open the ORCID record for Nita Bellare [Opens in a new window] ,
João Bana Open the ORCID record for João Bana [Opens in a new window] ,
Ana Flávia Santos Open the ORCID record for Ana Flávia Santos [Opens in a new window] ,
Sarah Charnaud Open the ORCID record for Sarah Charnaud [Opens in a new window] ,
Anna Laura Ross Open the ORCID record for Anna Laura Ross [Opens in a new window]  and
Mitchell J. Schwaber
...Show all authors
Benedetta Allegranzi*
Affiliation:
Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
Ermira Tartari
Affiliation:
Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland Faculty of Health Sciences, University of Malta, Msida, Malta
Claire Kilpatrick
Affiliation:
Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
Julie Storr
Affiliation:
Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
Nita Bellare
Affiliation:
Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
João Bana
Affiliation:
Decision Eyes, Lisbon, Portugal
Ana Flávia Santos
Affiliation:
CEGIST, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
Sarah Charnaud
Affiliation:
Research for Health Department, World Health Organization, Geneva, Switzerland
Anna Laura Ross
Affiliation:
Research for Health Department, World Health Organization, Geneva, Switzerland
Mitchell J. Schwaber
Affiliation:
National Center for Infection Control, Israel Ministry of Health, Jerusalem, Israel
Didier Pittet
Affiliation:
Faculty of Medicine, University of Geneva, Geneva, Switzerland
*
Corresponding author: Benedetta Allegranzi; Email: allegranzib@who.int
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Abstract

Objective:

To identify global research priorities for improving hand hygiene in healthcare settings and develop a 2023–2030 research agenda to guide funding, coordinate research, promote investment, and inform policy for enhanced healthcare quality and safety.

Design:

Expert consensus study using a modified Delphi process.

Participants:

A 105-member panel of international hand hygiene experts including the World Health Organization (WHO) Technical Advisory Group of Experts on Hand Hygiene in Healthcare representing all WHO regions and World Bank income levels.

Methods:

The research priorities were identified through a multiphase approach including a meta-review to establish knowledge gaps and inform initial priorities, followed by expert consultations using a modified Delphi process. 192 preliminary priorities were included in a two-round Delphi survey. Experts rated each priority in the first round, and then reviewed and adjusted responses based on the panel’s aggregated, anonymous responses in the second round. Ratings were collected on a five-point Likert scale. Consensus was defined as a combined “strongly agree” and “agree” frequency of at least 70%.

Results:

Consensus was achieved for 178 of 192 priorities (92.7%), categorized into six domains: system change; training and education; evaluation and feedback; reminders and communications; institutional safety climate; and hand hygiene improvement impact on healthcare-associated infections and antimicrobial resistance. Of these, 121 priorities reached >80% consensus. The Delphi process, maintained a 92% response rate over two rounds.

Conclusions:

A structured consensus process yielded a research agenda to address gaps in hand hygiene improvement, supporting enhanced healthcare quality and safety globally.

Information

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 46 , Issue 5 , May 2025 , pp. 449 - 464
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

*

These authors contributed equally to this work

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