- Meeting abstract
- Open Access
Hand hygiene compliance in a tertiary university hospital
Safety in Health volume 1, Article number: A13 (2015)
Health care-associated infections (HAI) are a major patient safety issue worldwide and several reports found that improved hand hygiene (HH) was associated with reduced HAI . Reasons for low adherence to HH are diverse  and the Joint Commission set the targeted goal for HH compliance to achieve > 90% .
In 2012 the University Hospital Graz initiated the campaign "Clean Hands" and paid particular attention to improving healthcare professionals' knowledge of the WHO's My Five Moments for HH . The main components of the campaign comprised training, distribution of posters and provision of materials encouraging patients and relatives to clean their hands. In 2013 and 2014 direct observations to assess HH compliance took part . The aim of this study was to assess the compliance of HH within professional groups in three different environments.
Material and methods
In total, 23 units (wards and intensive care units) were informed that direct observations will be performed by trained hygiene experts for the WHO's My Five Moments for Hand Hygiene model. Results are shown for a non-surgical ICU, surgical ICU and pediatric ward.
Phase 1 - baseline direct observation:Baseline direct observation took place and for each indication at least 20 direct observations had to be performed. The overall compliance was calculated when more than 150 direct observations in a unit had been performed. At the end of the direct observation feedback was given by hygiene experts.
Phase 2 - follow up direct observation:Each unit was given the opportunity to reflect their habits according to the baseline results. After 6 to 12 months, a follow up observation was performed and again feedback was given.
In a non-surgical ICU, the overall compliance rate increased from 53% to 83%, in a surgical ICU from 68% to 82% and in a pediatric ward from 85% to 91% (Table 1).
Compliance rates for all professional groups increased over time and were highest within "others" (Table 2).
HH is considered to be the most important measure to prevent nosocomial infections  and results of direct observations show that HH motivation can be addressed with comprehensive HH campaigns. Overall, improvements in the HH behavior were achieved for all indications and had been near or even above to the Joint Commission recommendation. The compliance rate for the professional group "others" showed the highest increase.
We would like to thank the entire organization and their employees for supporting the HH-campaign. We also would like to thank "National Reference Centre for the Surveillance of Nosocomial Infections" (http://www.nrz-hygiene.de) for data analysis.
Boyce JM: Update on hand hygiene. Am J Infect Control. 2013, 41 (5 Suppl): S94-S96.
Boyce JM, Pittet D: Healthcare Infection Control Practices Advisory Committee; HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Guideline for hand hygiene in health-care settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Am J Infect Control. 2002, 30 (8): S1-46.
World Health Organization. Patient Safety. WHO Guidelines on Hand Hygiene in Health Care. First global patient safety challenge clean care is safer care. 2009, (accessed 30 August 2014), [http://www.who.int/gpsc/5may/en/]
Erasmus V, Daha TJ, Brug H, et al: Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol. 2010, 283-294. 31
The authors declare that they have no competing interests.
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Pepper, K., Hörhan, H., Jeuschnigger, C. et al. Hand hygiene compliance in a tertiary university hospital. Saf Health 1, A13 (2015) doi:10.1186/2056-5917-1-S1-A13
- Direct Observation
- Nosocomial Infection
- Hand Hygiene
- Professional Group
- Compliance Rate