{
  "abstract": "Background Creating and sustaining an institutional climate conducive to patient and health worker safety is a critical element of successful multimodal hand hygiene improvement strategies aimed at achieving best practices. Repeated WHO global surveys indicate that the institutional safety climate consistently ranks the lowest among various interventions.Methods To develop an international expert consensus on research agenda priorities related to the role of institutional safety climate within the context of a multimodal hand hygiene improvement strategy, we conducted a structured consensus process involving a purposive sample of international experts. A preliminary list of research priorities was formulated following evidence mapping, and subsequently refined through a modified Delphi consensus process involving two rounds. In round 1, survey respondents were asked to rate the importance of each research priority. In round 2, experts reviewed round 1 ratings to reach a consensus (defined as ≥70% agreement) on the final prioritised items to be included in the research agenda. The research priorities were then reviewed and finalised by members of the WHO Technical Advisory Group on Hand Hygiene Research in Healthcare.Results Of the 57 invited participants, 50 completed Delphi round 1 (88%), and 48 completed round 2 (96%). Thirty-six research priority statements were included in round 1 across five thematic categories: (1) safety climate; (2) personal accountability for hand hygiene; (3) leadership; (4) patient participation and empowerment and (5) religion and traditions. In round 1, 75% of the items achieved consensus, with 9 statements carried forward to round 2, leading to a final set of 31 prioritised research statements.Conclusion This research agenda can be used by researchers, clinicians, policy-makers and funding bodies to address gaps in hand hygiene improvement within the context of an institutional safety climate, thereby enhancing patient and health worker safety globally.",
  "authors": [
    {
      "affiliations": [
        "Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland",
        "Faculty of Health Sciences, University of Malta, Msida, Malta"
      ],
      "name": "Ermira Tartari"
    },
    {
      "affiliations": [
        "Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland"
      ],
      "name": "Julie Storr"
    },
    {
      "affiliations": [
        "Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland"
      ],
      "name": "Nita Bellare"
    },
    {
      "affiliations": [
        "Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland"
      ],
      "name": "Claire Kilpatrick"
    },
    {
      "affiliations": [
        "Retired or Former, University of Pennsylvania Faculty, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Maryanne McGuckin"
    },
    {
      "affiliations": [
        "National Center for Infection Control, Israel Ministry of Health, Jerusalem, Israel"
      ],
      "name": "Mitchell J Schwaber"
    },
    {
      "affiliations": [
        "Faculty of Medicine, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Didier Pittet"
    },
    {
      "affiliations": [
        "Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland"
      ],
      "name": "Benedetta Allegranzi"
    }
  ],
  "title": "WHO research agenda on the role of the institutional safety climate for hand hygiene improvement: a Delphi consensus-building study",
  "uid": "e095aa73-87da-58a0-9a64-c90960fce9a2"
}