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  • Measure Summary
  • NQMC:005013

Hand washing: does the hospital have appropriate infrastructure for hand washing in all units of the hospital in which patient care is administered?

Ministry of Health. Safe practices indicators project: background, summary of methods and measurement strategies. Madrid: Ministry of Health; 2009 Feb 20. 97 p.

This is the current release of the measure.

Primary Measure Domain

Structure

The validity of measures depends on how they are built. By examining the key building blocks of a measure, you can assess its validity for your purpose. For more information, visit the Measure Validity page.

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to determine whether or not the hospital has appropriate infrastructure for hand washing (washbasins, supplies of soap/alcohol gel hand cleaners) in all units of the hospital in which patient care is administered.

Rationale

Although hand washing has been shown to be highly effective in preventing the transmission of pathogens within a hospital, studies have repeatedly shown that hand washing compliance rates are generally less than 50 percent.

The existence of adequate infrastructure (washbasins provided with soap and antiseptic solution/alcohol gel hand cleaners) indicates that the hospital complies with this fundamental structural quality criterion that facilitates hand washing.

Primary Clinical Component

Infrastructure for hand washing (washbasins, supplies of soap/alcohol gel hand cleaners)

Denominator Description

This measure applies to hospitals (one hospital at a time).

Numerator Description

The hospital has appropriate infrastructure for hand washing (washbasins, supplies of soap/alcohol gel hand cleaners) in all units of the hospital in which patient care is administered (see the related "Numerator Inclusions/Exclusions" field).

Evidence Supporting the Criterion of Quality

A clinical practice guideline or other peer-reviewed synthesis of the clinical evidence

A formal consensus procedure involving experts in relevant clinical, methodological, and organizational sciences

A systematic review of the clinical literature

One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Need for the Measure

Use of this measure to increase capacity

Evidence Supporting Need for the Measure

Ministerio de Sanidad y Consumo. Indicadores de buenas practicas sobre seguridad del paciente. Resultados de su medicion en una muestra de hospitales del sistema nacional de salud Español. Madrid: Ministerio de Sanidad y Consumo; 2008. 95 p.

State of Use

Current routine use

Current Use

Internal quality improvement

Care Setting

Hospitals

Professionals Responsible for Health Care

Measure is not provider specific

Lowest Level of Health Care Delivery Addressed

Single Health Care Delivery Organizations

Target Population Age

Does not apply to this measure

Target Population Gender

Does not apply to this measure

Stratification by Vulnerable Populations

Does not apply to this measure

Source(s)

Ministry of Health. Safe practices indicators project: background, summary of methods and measurement strategies. Madrid: Ministry of Health; 2009 Feb 20. 97 p.

Incidence/Prevalence

48% of hospitals have some room for improvement in relation to infrastructure for hand washing in the units of the hospital in which patient care is administered.

Evidence for Incidence/Prevalence

Ministerio de Sanidad y Consumo. Indicadores de buenas practicas sobre seguridad del paciente. Resultados de su medicion en una muestra de hospitales del sistema nacional de salud Español. Madrid: Ministerio de Sanidad y Consumo; 2008. 95 p.

Association with Vulnerable Populations

Unspecified

Burden of Illness

Unspecified

Utilization

Unspecified

Costs

Unspecified

IOM Care Need

Not within an IOM Care Need

IOM Domain

Not within an IOM Domain

Case Finding

Does not apply to this measure

Denominator Sampling Frame

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
This measure applies to hospitals (one hospital at a time).

Exclusions
None

Relationship of Denominator to Numerator

Does not apply to this measure

Denominator (Index) Event

Does not apply to this measure

Denominator Time Window

Does not apply to this measure

Numerator Inclusions/Exclusions

Inclusions
The hospital has appropriate infrastructure* for hand washing (washbasins, supplies of soap/alcohol gel hand cleaners) in all units of the hospital in which patient care is administered.

*The following are considered appropriate infrastructure:

  • One washbasin with soap and antiseptic solution per intensive care unit (ICU) patient
  • One washroom area per operating room
  • At least one washbasin per nursing area in conventional wards
  • Disposable towels

Availability of alcohol-based hand rub may be assessed also.

Different areas of hospital to be assessed:

  • ICU
  • A ward at random
  • An operating room at random

Exclusions
None

Measure Results Under Control of Health Care Professionals, Organizations and/or Policymakers

The measure results are somewhat or substantially under the control of the health care professionals, organizations and/or policymakers to whom the measure applies.

Numerator Time Window

Encounter or point in time

Data Source

Special or unique data

Level of Determination of Quality

Does not apply to this measure

Pre-existing Instrument Used

None

Scoring

Categorical Variable

Interpretation of Score

Passing score defines better quality

Allowance for Patient Factors

Does not apply to this measure

Standard of Comparison

Internal time comparison

Extent of Measure Testing

After pilot testing, the set of indicators has been measured in a random sample of 25 Spanish hospitals, stratified by hospital size. The main objective has been to field test the feasibility of measurement in the various settings representing real life situations in the context of the Spanish Health Care System.

Both the whole indicators validation report and the results of the baseline measurement in a sample of the Spanish National Health Service (NHS) hospitals may be accessed and downloaded from the Spanish Ministry of Health web page (in Spanish):

Evidence for Reliability/Validity Testing

Ministerio de Sanidad y Consumo. Construccion y validacion de indicadores de buenas practicas sobre seguridad del paciente. Madrid: Ministerio de Sanidad y Consumo; 2008. 178 p.

Ministerio de Sanidad y Consumo. Indicadores de buenas practicas sobre seguridad del paciente. Resultados de su medicion en una muestra de hospitales del sistema nacional de salud Español. Madrid: Ministerio de Sanidad y Consumo; 2008. 95 p.

Ministry of Health. Safe practices indicators project: background, summary of methods and measurement strategies. Madrid: Ministry of Health; 2009 Feb 20. 97 p.

Original Title

Existence of washbasins provided with soap and antiseptic solution/alcohol gel hand cleaners (dispensing units or single-use handrubs) easily accessible to healthcare workers.

Measure Collection Name

Safe Practices Indicators Project

Measure Set Name

Adopting Safe Practices in Specific Clinical Care Settings or for Specific Processes of Care

Measure Subset Name

Promotion of Hand Washing in Health Personnel

Submitter

Spanish Agency for Healthcare Quality of the Spanish Ministry of Health

Developer

Grupo de Investigación sobre Gestión de la Calidad en Servicios de Salud, University of Murcia, under contract to the Spanish Ministry of Health

Funding Source(s)

Agency for Quality, Spanish Ministry of Health

Composition of the Group that Developed the Measure

Saturno, Pedro J., MD, DrPH; Group Director and Project PI

Castillo, Carmen; López, M. José; Ramón, Teresa; Nurses

Carrillo, Andrés, MD; Intensive Care Specialist

Iranzo, M. Dolores; Hospital pharmacist

Soria, Victor, MD; Surgeon

Parra, Pedro, MD; Gomis, Rafael, MD; Gascón, Juan J., MD; Quality Management Specialists

Financial Disclosures/Other Potential Conflicts of Interest

Project entirely financed by the Spanish Ministry of Health.

Adaptation

Measure was not adapted from another source.

Release Date

2009 Feb

Measure Status

This is the current release of the measure.

Measure Availability

The individual measure, "Existence of Washbasins Provided with Soap and Antiseptic Solution/Alcohol Gel Hand Cleaners (Dispensing Units or Single-use Handrubs) Easily Accessible to Healthcare Workers," is published in "Safe Practices Indicators Project: Background, Summary of Methods and Measurement Strategies."

For more information, contact:

  • Ministry of Health and Social Policy, Paseo del Prado, 18-20, planta baja, esquina con Lope de Vega. 28014 Madrid; Phone: +34 901 400 100; Fax: +34 915 96 44 80; Web site: www.msc.es/en/home.htm External Web Site Policy.
    OR
  • Pedro J. Saturno, Facultad de Medicina, Universidad de Murcia, 30100 Espinardo-Murcia (Spain); Phone: 868 883 948; Fax: +34 868 883947; E-mail: psaturno@um.es; Web site: http://www.calidadsalud.com External Web Site Policy.

Companion Documents

The following are available:

  • Ministerio de Sanidad y Consumo. Construccion y validacion de indicadores de buenas practicas sobre seguridad del paciente. Madrid: Ministerio de Sanidad y Consumo; 2008. 178 p. This document is available in Portable Document Format (PDF) from the Ministry of Health and Social Policy Web site External Web Site Policy (in Spanish).
  • Ministerio de Sanidad y Consumo. Indicadores de buenas practicas sobre seguridad del paciente. Resultados de su medicion en una muestra de hospitales del sistema nacional de salud Español. Madrid: Ministerio de Sanidad y Consumo; 2008. 95 p. This document is available in PDF from the Ministry of Health and Social Policy Web site External Web Site Policy (in Spanish).

NQMC Status

This NQMC summary was completed by ECRI Institute on September 11, 2009. The information was verified by the measure developer on December 23, 2009.

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