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The Joint Commission sets and reviews National Patient Safety Goals (NPSGs) for various healthcare settings, including ambulatory, home care, hospital, laboratory, and nursing centers. The aim of the Infection Prevention Goal is to reduce the risk of healthcare-associated infections (HCAIs) in various settings by maintaining and promoting hand hygiene. The NPSGs were first established in 2002, and they are updated periodically to constantly improve hand cleaning practices and reduce the rate of HCAIs. The 2021 NPSGs were reviewed in the 2020 goals, and they became effective in January 2021.
The infection prevention goal emphasizes compliance with the Centers for Disease Control and Prevention’s (CDC) or the World Health Organization (WHO) hand cleaning guidelines (Joint Commission, 2020). The two agencies provide a comprehensive framework composed of evidence-based interventions for improving hand hygiene and reducing the risk of HCAIs. The HCAIs prevention standard requires healthcare facilities to conduct a frequent assessment of their compliance with the relevant guidelines through “a comprehensive program that provides a hand hygiene policy, fosters a culture of hand hygiene, monitors compliance, and provides feedback” (Joint Commission, 2020, p. 8). Adherence to these requirements can help enhance hand hygiene practices and reduce the risk of HCAIs.
The rationale for this goal is the high incidence and financial burden of HCAIs in healthcare settings. Millions of people get infected when receiving care, treatment, and other health-related services. A survey on HCAIs prevalence in the U.S. clinical facilities established that about 4% of hospitalized patients had acquired an infection (Magill et al., 2018). A report by WHO (2013) indicated that HCAIs cost the American government $6.8 billion annually (as cited in Saleem et al., 2019). Consequently, the high prevalence of HCAIs and the accompanying financial burden make hand hygiene promotion a priority issue that requires more attention.
Implementation of hand hygiene programs has led to significant positive results in compliance among healthcare personnel. Cleaning hands regularly using soap, sanitizers, and other disinfectants minimizes the incidence and transmission of HCAIs in different healthcare settings. Scholars and practitioners agree that the hands of nurses, physicians, and other healthcare personnel are the primary mode of spreading pathogenic microorganisms in hospitals (Farhoudi et al., 2016). In this regard, complying with the recommended hand hygiene guidelines can minimize the transmission of infectious agents by hospital personnel to patients, consequently reducing the rate of infections.
Empirical evidence shows that hand cleaning promotion is effective in preventing HCAIs. The results of a study conducted in Iran reported: “a significant change in compliance before and after implementation of WHO’s Multimodal HH Improvement Strategy (29.8% and 70.98%, respectively)” (Farhoudi et al., 2016, p. 1). A related survey on Finish nurse’s and doctors’ hygiene practices established a substantial increase in annual hand-hygiene compliance (76.4%-88.5%) between 2013 and 2018 (Ojanperä et al., 2020). The internal audit survey further found a significant decline in the number incidence of HCAIs, falling from 2012 to 1831 (Ojanperä et al., 2020). The results of the investigation showed a drop in the incidence per 1000 patient-days from 14.0 to 11.7. A 13.5-month prospective, randomized cluster controlled trial conducted by Arbogast et al. (2016) reported consistent findings showing a 20% drop in Hygiene-preventable healthcare claims among employees in the intervention group. Therefore, the WHO and CDC guidelines on infection prevention have improved hand hygiene compliance among clinical personnel, consequently reducing the high incidence of HCAIs in healthcare settings.
References
Arbogast, J. W., Moore-Schiltz, L., Jarvis, W. R., Harpster-Hagen, A., Hughes, J., & Parker, A. (2016). Impact of a comprehensive workplace hand hygiene program on employer healthcare insurance claims and costs, absenteeism, and employee perceptions and practices.Journal of Occupational and Environmental Medicine, 58(6), 231-240. Web.
Farhoudi, F., Sanaei Dashti, A., Hoshangi Davani, M., Ghalebi, N., Sajadi, G., & Taghizadeh, R. (2016). Impact of WHO hand hygiene improvement program implementation: A quasi-experimental trial.BioMed Research International, 2016. Web.
Joint Commission. (2020). National patient safety goals effective January 2021 for the hospital program. Web.
Magill, S. S., O’Leary, E., Janelle, S. J., Thompson, D. L., Dumyati, G., Nadle, J., Wilson, L. E., Kainer, A., Lynfield, R., Greissman, S., Ray, S.M., Beldavs, Z., Gross, C., Bamberg, W., Sievers, M., Concannon, C., Buhr, N., Warnke, L., Maloney, M., … Edwards, J. R. (2014). Changes in prevalence of healthcare–associated infections in US hospitals.New England Journal of Medicine, 379(18), 1732-1744. Web.
Ojanperä, H., Kanste, O. I., & Syrjala, H. (2020). Hand-hygiene compliance by hospital staff and incidence of health-care-associated infections, Finland.Bulletin of the World Health Organization, 98(7), 475-483. Web.
Saleem, Z., Godman, B., Hassali, M. A., Hashmi, F. K., Azhar, F., & Rehman, I. U. (2019). Point prevalence surveys of health-care-associated infections: A systematic review. Pathogens and Global Health, 113(4), 191-205. Web.
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