Hand-hygiene compliance remains a persistent challenge in healthcare, particularly in high-risk patient areas such as the intensive care unit (ICU). The source article frames poor compliance as a continued problem and highlights that interventions combining active surveillance, peer-to-peer coaching and collective action have previously been suggested as potentially effective strategies to improve adherence to hand-hygiene standards.
The study described in the source focused on operationalizing one such approach by introducing a dedicated role — the hand-hygiene champion (HHC) — embedded within the ICU environment.
The stated aim was to implement the hand-hygiene champion role with the objective of increasing hand-hygiene compliance rates within the ICU. The intent was to assess whether the presence and embedding of HHCs would be associated with improved compliance compared with standard practice.
Design and setting
The project was conducted as a quality improvement initiative within the critical care directorate spanning two tertiary hospital sites in the United Kingdom. The implementation period ran from February 2025 through February 2026.
Improvement framework
The project followed the Plan-Do-Study-Act (PDSA) cycle as its implementation and evaluation framework. The source indicates the HHC role was introduced and integrated across the intervention site(s) following this iterative QI methodology.
Intervention details
The core intervention was the creation and embedding of the hand-hygiene champion role. According to the source, the role incorporated elements of active surveillance, peer-to-peer coaching and fostering collective action among staff. Specific operational details — such as the number of champions appointed, criteria for selection, training content, frequency and duration of champion-led activities, and the exact mechanisms used for surveillance and coaching — were not reported in the source and therefore cannot be asserted here.
Comparison and measurement
The source reports that compliance rates were compared between groups with HHCs (intervention) and control groups without the role. The exact measurement methods, observation schedules, denominators, baseline compliance rates, sample sizes, and statistical approaches used to determine significance were not reported in the abstract and therefore are not available from this source.
The source reports two primary outcomes:
Hand-hygiene compliance rates were significantly higher in the intervention group where HHCs had been embedded compared with the control group.
Hand-hygiene compliance rates increased significantly over time after the implementation of the HHC role.
No further quantitative data (for example, absolute compliance percentages, relative increases, confidence intervals, p-values, or the number of observations) are provided in the source abstract. As such, precise effect sizes and statistical details cannot be reproduced here.
The authors conclude that introducing and embedding the hand-hygiene champion role can potentially improve hand-hygiene compliance in ICUs. The source frames this as a promising quality improvement approach that used active surveillance, peer coaching and collective action within a PDSA framework to achieve measurable improvements in compliance.
The article reports no declared conflicts of interest.
Authors listed in the source: Mary Grace Anne Batalla, Yumna Mohammad Sali and Alvin Cortuna. All authors are affiliated with the critical care directorate at Guy’s and St Thomas’ NHS Foundation Trust, London, with roles described as Critical Care Senior Staff Nurse and NIHR Predoctoral Fellow (Batalla), Critical Care Sister (Sali) and Critical Care Senior Staff Nurse (Cortuna).
Publication and identifiers: The study appears in British Journal of Nursing (Br J Nurs), published online 5 August 2026 and in print 6 August 2026; PMID 42555589; DOI 10.12968/bjon.2026.0136.
Conflict of interest: The source states a declaration of interest of none.
Limitations in source reporting
This summary is limited to the information provided in the source abstract and bibliographic record. The abstract reports statistically significant improvements but does not supply sample sizes, baseline rates, numeric outcomes, or details of the champion role implementation (selection, training, time commitment) and observation methodology. Those operational and quantitative details were not reported in the source abstract and therefore are not available here.
Keywords reported in the source include Hand hygiene; Hand-hygiene champion; Handwashing; Infection control; Intensive care.
Overall, the source supports the conclusion that embedding a dedicated hand-hygiene champion role, implemented through a PDSA quality improvement approach, was associated with improved hand-hygiene compliance in ICU settings at the two UK tertiary hospital sites studied.