There are considerable challenges associated with healthcare environmental hygiene (HEH) practices in healthcare facilities (HCFs) worldwide, according to a study published in the American Journal of Infection Control. Alexandra Peters, MA, PhD-candidate, and colleagues conducted a pilot survey to test a version of a framework for HEH self-assessment. The online survey was sent to 743 HCFs; 51 HCFs from 35 countries participated. The survey was based on the Multimodal Hand Hygiene Improvement Strategy, which includes questions on participant and facility characteristics, protocols, practices, staffing, training, management, work culture, and survey appropriateness. The researchers found that 50 of 51 HCFs were lacking in some or all of the five components of the WHO multimodal strategy (availability of appropriate cleaning products and supplies, training and education, monitoring and feedback, reminders in the workplace, and institutional safety climate). “From the data gathered, it is obvious that there are major resource, structural, and cultural challenges to HEH implementation,” the authors wrote.