Evidence map›Paper›PMID 39366744›Full record

ArticleBMJ quality & safety2025

WHO research agenda on the role of the institutional safety climate for hand hygiene improvement: a Delphi consensus-building study.

Ermira Tartari, Julie Storr, Nita Bellare, Claire Kilpatrick, Maryanne McGuckin, Mitchell J Schwaber, Didier Pittet, Benedetta Allegranzi

Abstract readConsensus Statement
In one paragraph

Article in BMJ quality & safety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ermira TartariInfection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland ermira.tartari@gmail.com.ORCID http://orcid.org/0000-0002-9791-644X
Julie StorrInfection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland.ORCID http://orcid.org/0000-0002-3052-2905
Nita BellareInfection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland.
Claire KilpatrickInfection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland.ORCID http://orcid.org/0000-0002-5680-8549
Maryanne McGuckinRetired or Former, University of Pennsylvania Faculty, Philadelphia, Pennsylvania, USA.
Mitchell J SchwaberNational Center for Infection Control, Israel Ministry of Health, Jerusalem, Israel.
Didier PittetFaculty of Medicine, University of Geneva, Geneva, Switzerland.ORCID http://orcid.org/0000-0002-3667-7131
Benedetta AllegranziInfection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland.ORCID http://orcid.org/0000-0002-7038-1297

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundCreating and sustaining an institutional climate conducive to patient and health worker safety is a critical element of successful multimodal hand hygiene improvement strategies aimed at achieving best practices. Repeated WHO global surveys indicate that the institutional safety climate consistently ranks the lowest among various interventions.

methodsTo develop an international expert consensus on research agenda priorities related to the role of institutional safety climate within the context of a multimodal hand hygiene improvement strategy, we conducted a structured consensus process involving a purposive sample of international experts. A preliminary list of research priorities was formulated following evidence mapping, and subsequently refined through a modified Delphi consensus process involving two rounds. In round 1, survey respondents were asked to rate the importance of each research priority. In round 2, experts reviewed round 1 ratings to reach a consensus (defined as ≥70% agreement) on the final prioritised items to be included in the research agenda. The research priorities were then reviewed and finalised by members of the WHO Technical Advisory Group on Hand Hygiene Research in Healthcare.

resultsOf the 57 invited participants, 50 completed Delphi round 1 (88%), and 48 completed round 2 (96%). Thirty-six research priority statements were included in round 1 across five thematic categories: (1) safety climate; (2) personal accountability for hand hygiene; (3) leadership; (4) patient participation and empowerment and (5) religion and traditions. In round 1, 75% of the items achieved consensus, with 9 statements carried forward to round 2, leading to a final set of 31 prioritised research statements.

conclusionThis research agenda can be used by researchers, clinicians, policy-makers and funding bodies to address gaps in hand hygiene improvement within the context of an institutional safety climate, thereby enhancing patient and health worker safety globally.

Indexed as

Hand HygieneOrganizational CultureQuality ImprovementSafety ManagementConsensusDelphi TechniqueHumansPatient SafetyWorld Health Organizationhealthcare quality improvementinfection controlsafety culture

Identifiers

PMID39366744
PMCPMC12418544

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.