from the editor
from the editor
Avoiding Policy Wars Around Hand Hygiene Practices
this issue, we cover the recent Society
In for Healthcare Epidemiology of America( SHEA) town hall addressing tough topics in hand hygiene. The perennial challenges persist, with clinical experts doing their best to share insights and best practices, and we know that the needle doesn’ t move very far when it comes to tackling issues fraught with human behavior-related obstacles.
It’ s a shame when hand hygiene also becomes complicated by potential clinical-political issues that are thinly veiled under the umbrella of accepted policy. In mid-August, the Association for Professionals in Infection Control and Epidemiology( APIC) issued a formal request to The Leapfrog Group urging a revision of its hand hygiene observation requirements, citing a critical misinterpretation of the World Health Organization( WHO)’ s guidance.
In a letter sent to Leah Binder, Leapfrog’ s president and CEO, APIC CEO Devin Jopp emphasized that Leapfrog’ s current standard of 100 to 200 observations per hospital unit per month is not supported by WHO’ s 2009 guidelines. As APIC explains it, contrary to Leapfrog’ s interpretation, WHO does not prescribe a fixed monthly minimum. Instead, it recommends a cumulative approach, as in 12 to 15 observations per denominator, repeated over several weeks, totaling 150 to 200 observations over time to ensure statistical significance. This clarification was provided directly to APIC in response to a formal inquiry submitted to the WHO.
“ Leapfrog’ s requirement is based on a misinterpretation of WHO’ s intent,” Jopp commented in a statement.“ This standard has led to excessive observation burdens that divert critical resources away from more impactful infection prevention efforts.”
In an analysis of more than 800,000 hand hygiene observations, APIC’ s Center for Research, Practice, and Innovation( CRPI) found that 50 observations per unit per month are sufficient to maintain data quality and detect meaningful compliance trends. APIC maintains this evidence-based approach aligns with WHO’ s clarified guidance and reflects the operational realities faced by infection prevention professionals nationwide.
APIC is calling on Leapfrog to revise its standard to reflect what it calls a“ more practical and scientifically sound baseline.” Additionally, APIC recommends that Leapfrog recognize facilities that exceed the baseline through commendations, rather than tying core scoring or rankings to higher observation volumes.
“ We welcome the opportunity to partner with Leapfrog on a solution that supports both rigorous quality measurement and practical implementation,” Jopp said.
Let’ s hope the two organizations can find an acceptable stance so that clinicians aren’ t further confused, this making an already-difficult practice fraught with policy wars.
Until next time, bust those bugs!
Kelly M. Pyrek Editor & Publisher Kelly @ healthcarehygienemagazine. com healthcarehygienemagazine
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4 • www. healthcarehygienemagazine. com • sept-oct 2025