Skip to main content

Table 3 Case Scenario 3 to simulate the completion of the WHO Hand Hygiene Self Assessment Framework (HHSAF)

From: Scenario-based simulation training for the WHO hand hygiene self-assessment framework

Case Scenario HHSAF Component Subtotal Score
The Ulwazi National Referral Hospital is a national referral and teaching tertiary care institution with 900 beds providing both primary and specialized health care (maternity, hemodialysis, intensive care units, medical and surgical specialties).   
HH supplies (i.e. ABHR, soap and disposable towels) are scarce in the facility, with the availability of ABHR being confined to specialty areas such as Maternity, Hemodialysis and Intensive Care Units. The ABHR efficacy and tolerability have not been proven. The other wards use soap for handwashing and do not have disposable paper towels. Soap supplies are erratic and, at times, not available. The soap is very harsh to the skin. The wards have sinks with running water. The sinks are installed in the following areas in the ward: • 1 in the nursing station• 1 in the procedure/treatment room• 2 sinks per ward (25 beds) • 1 sink for the patient wash and toilet areas System Change 10/100
HH training is done as part of in-service education, upon employment. When newly employed staff members are trained in HH, they enter their names and signatures in a register, kept as a record that all HCWs completed the training. Student nurses are given the HH training in their 1st and 3rd year of undergraduate education. The student nurses are attached for clinical practice in the hospital and have contact with the patients from the first year. The WHO leaflets on ‘Glove Use Information’ and “Hand Hygiene: Why, How and When” are available. Training and Education 50/100
Audits to assess the availability and consumption of HH products is not performed, as the hospital lacks human resources. HH compliance rates are not monitored. The IPC nurse has not been trained as a hand hygiene compliance observer. Evaluation and Feedback 0/100
Posters displaying the WHO ‘My 5 Moments of Hand Hygiene’, ‘How to Hand Rub’ and ‘How to handwash’ are displayed next to all the hospital’s sinks. Reminders in the workplace 50/100
The Ulwazu facility has registered for the WHO Clean Care is Safer Care global campaign and is commemorating the Hand Hygiene Day every 5th of May. Institutional Safety Climate 10/100
  Total Score 120/500
  1. Abbreviations: ABHR Alcohol-based handrub, HH Hand hygiene