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Table 4 Levels of Hand Hygiene Implementation Progress Defined by the WHO Hand Hygiene Self-Assessment Framework (HHSAF)

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

Level of Progress HHSAFScore Definition
Inadequate 0–125 Hand hygiene practices and promotion are deficient. Significant improvement is required
Basic 126–250 Some measures are in place, but not at a satisfactory standard. Further improvement is required
Intermediate 251–375 An appropriate hand hygiene promotion strategy is in place, and hand hygiene practices have improved. It is now crucial to develop long-term plans to ensure that improvement is sustained and progresses
Advanced 376–500 Hand hygiene promotion and optimal hand hygiene practices have been sustained and/or improved, helping to embed a culture of safety in the healthcare setting
Leadershipa   The healthcare facility is considered as a reference center for and contributes to the promotion of hand hygiene through research, innovation and information sharing
  1. aThe healthcare facility reached the Advanced level and in addition meets at least 12 out of 20 leadership criteria and at least one leadership criterion per each category