Background: Healthcare-associated infections (HAIs) are a major threat to patient safety worldwide. The importance of the healthcare environment in patient care is not always adequately addressed. Currently, no overview exists of how healthcare environmental hygiene (HEH) is performed around the world.

Methods: Our pilot survey tested a preliminary version of a framework for HEH self-assessment. It aimed to gather data to improve the framework as well as evaluate the strengths and challenges in HEH programs around the world, and across resource levels. The survey was developed by a group of experts, and based on the hand hygiene multimodal improvement strategy. The online survey was sent to 743 healthcare facilities (HCFs) from all of the World Bank income levels, aiming for at least four participants from each level. Overall responses were analyzed as a group as well as stratified per income level using OpenEpi.

Results: Overall, 51 HCFs from 35 countries participated. Almost all HCFs surveyed (50/51, 98%) were found lacking in some or all of the five components of the WHO multimodal strategy independent of income level. The results demonstrate the widespread challenges in HEH institutions are facing around the world.

Conclusion: The feedback from survey participants allowed for the improvement of the self-assessment tool. There is a clear need for more focus on and investment in HEH programs in HCFs worldwide.