Dr Jude Robinson has written this guest post in preparation for Journal Club on Wednesday this week (register here).

I am looking forward to this week’s journal club where I will be discussing the following paper by Watanabe et al. (2025), “The effect of a patient empowerment hand hygiene programme: a single-centre study in Japan”, investigates whether patient involvement can improve healthcare worker (HCW) compliance with hand hygiene (HH) at Tokyo Medical University Hospital.

Objective

The study aimed to assess the effect of a structured patient empowerment programme, in which patients were encouraged to actively remind HCWs to perform HH. This intervention sought to provide patients with both the permission and tools to prompt staff about handwashing, thereby introducing a shared responsibility for infection prevention.

Findings

The implementation of the programme resulted in a statistically significant increase in HH events per patient-day. Importantly, this indicates not only improved compliance but also a higher frequency of HH opportunities being acted upon. A positive correlation was observed between the number of HH events and the intervention, suggesting that patient prompting was directly associated with better HCW adherence. The study demonstrated that patients could safely be engaged in reminding HCWs, and that such engagement produced measurable behavioural effects.

Implications for Practice

This work adds to the growing evidence that patient empowerment can be a viable strategy for influencing HCW behaviour in infection prevention and control. It highlights the feasibility of incorporating patient-centred interventions into HH promotion strategies, which have traditionally focused on staff training and monitoring. By empowering patients, healthcare systems can strengthen safety culture and create an additional mechanism to address the persistent challenge of suboptimal HH compliance.

Limitations

While promising, several limitations warrant consideration. The study does not discuss in detail patient comfort with speaking up, which may vary culturally and individually. The willingness and consistency of patients in prompting HCWs could influence outcomes, and long-term sustainability of the intervention remains uncertain. Moreover, measuring HH events per patient-day provides a useful quantitative marker, but it does not necessarily reflect the quality of HH technique or whether all appropriate opportunities were captured.

Conclusion

Overall, this study provides compelling evidence that patient empowerment is both feasible and effective in enhancing HH compliance. However, future research should examine sustainability, cultural acceptability, and the qualitative aspects of HH behaviour to fully establish its role in infection prevention strategies.

Hope you can join us for Journal Club to discuss this paper! If not, you can watch out for the recording and watch back previous Journal Clubs here.