Compliance with hand hygiene and glove use in a university-affiliated hospital

OBJECTIVE: The hands of healthcare workers often transmit pathogens causing nosocomial infections. This study examined compliance with handwashing and glove use. SETTING: A university-affiliated hospital. DESIGN: Compliance was observed covertly. Healthcare workers' demographics, hand hygiene facilities, indications for hand hygiene, compliance with handwashing and glove use in each procedure, and duration of handwashing were recorded. RESULTS: Nine nurses and 33 assistant physicians were monitored during the study. One researcher recorded 1,400 potential opportunities for handwashing during 15-minute observation periods. The mean duration of handwashing was 10 +/- 2 seconds. Most healthcare workers (99.3%) used liquid soap during handwashing, but 79.8% did not dry their hands. For all indications, compliance with handwashing was 31.9% and compliance with glove use was 58.8%. Compliance with handwashing varied inversely with both the number of indications for hand hygiene and the number of patient beds in the hospital room. Compliance with handwashing was better in dirty high-risk situations. CONCLUSION: Compliance with handwashing was low, suggesting the need for new motivational strategies such as supplying feedback regarding compliance rates.