Hand hygiene promotion system assessment in a long-term care facility in Qatar: a cross-sectional evaluation using the WHO Self-Assessment Framework
DOI:
https://doi.org/10.63950/gshh.2026.2.2.54Keywords:
Hand hygiene, Guideline adherence, Long-term care, Patient safety, QatarAbstract
Introduction: Healthcare-associated infections cause substantial morbidity. Hand hygiene is the most effective preventive measure, but compliance is suboptimal, especially in long-term care. We assessed the hand hygiene promotion system at a long-term care facility in Qatar using a validated WHO tool, focusing on system readiness rather than directly observed compliance.
Methods: A cross-sectional facility self-assessment was conducted (March–April 2016) at Enaya Specialised Care Centre, Hamad Medical Corporation, Doha. Ten nursing staff were randomly selected to complete the WHO Hand Hygiene Self-Assessment Framework (27 indicators, five domains: System Change, Training and Education, Evaluation and Feedback, Workplace Reminders, Institutional Safety Climate). Descriptive statistics were used; total scores (0–500) were categorised into four WHO levels (Inadequate, Basic, Intermediate, and Advanced).
Results: The facility scored 327.5/500 – Intermediate (Consolidation) level. Domain scores: Workplace Reminders 96/100, System Change 84/100, Training and Education 80/100, Safety Climate 40/100, Evaluation and Feedback 27.5/100. All participants reported irregular direct observation, no immediate feedback to healthcare workers, no regular hand hygiene team meetings, and no formal patient engagement programme. No participant knew the facility’s actual hand hygiene compliance rate.
Conclusion: The facility has strong infrastructure, mandatory training, and visual reminders, achieving an Intermediate system level. However, major gaps exist in monitoring, feedback, and safety climate – areas that measure actual behavioural reinforcement, not just infrastructure. Priority actions include routine direct observation, real-time feedback, hand hygiene champions, and formal WHO Day observance. These findings reflect system readiness, not observed compliance, and should be interpreted as a baseline for quality improvement.
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The anonymised dataset generated and analysed during the current study is available from the corresponding author on reasonable request.
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Copyright (c) 2026 Oyinloye CMA, Olu-Abiodun OO, Adepoju AA
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