Hand hygiene – a medical or socio-cultural issue? Results of a long-term observation.

Healthcare-associated infections (HAIs) are a global challenge in modern healthcare. One of the most accessible and effective strategies for preventing HAIs is regular hand hygiene by healthcare personnel. Despite its apparent simplicity, maintaining a high level of compliance with hand hygiene standards among healthcare workers remains an extremely difficult task, requiring new approaches and solutions. The key to understanding this issue may lie in the maturity of organizational culture – specifically, one of its components: safety culture. In healthcare, safety culture refers to an organizational environment where the prevention of errors and the minimization of risks to patients are prioritized. It encompasses shared values, attitudes, and behavior patterns aimed at ensuring safe care delivery. According to current perspectives, the level of safety culture can be assessed using specialized survey tools. This opens up the possibility of exploring how the sociocultural aspects of healthcare work contribute to the emergence of adverse events, errors, and other critical challenges in modern medicine. The aim of this study is to assess the relationship between safety culture indicators and healthcare workers’ adherence to hand hygiene practices. Methods. A retrospective observational study was conducted at the multidisciplinary clinic JSC «Medicina» in Moscow from 2014 to 2020. Annual safety culture assessments were carried out using the SOPS Hospital Survey 1.0. Hand hygiene compliance was evaluated based on a multi-level monitoring system developed in accordance with the Joint Commission International (JCI) International Patient Safety Goals (IPSG 5). Results. The strongest correlations were identified between hand hygiene adherence and the following components of safety culture: “staffing”, “supervisor/manager expectations and actions promoting patient safety”, “management support for patient safety”, “communication openness”, and the “overall perception of patient safety”. Conclusions. The findings confirm that an organization’s safety culture significantly influences healthcare workers’ adherence to hand hygiene protocols. Strengthening safety culture fosters a deeper understanding of the importance of hand hygiene as a means of protecting patients. Therefore, enhancing the level of safety culture is a necessary condition for improving hand hygiene compliance in healthcare facilities. The results of this study may be of interest to a broad audience concerned with patient safety in healthcare.