American Journal of Infection Control
Steed, Connie; Kelly, J. William; Blackhurst, Dawn; Boeker, Sue; Diller, Thomas; Alper, Paul; & Larson, Elaine
This benchmark study aimed to establish baseline estimates for hand hygiene opportunities across different hospital settings and clinical areas by conducting direct observations using the WHO monitoring methodology. Researchers collected data from two hospital types (large teaching and small community hospitals) across three clinical areas (medical-surgical ICUs, general medical wards, and emergency departments), observing 6,640 hand hygiene opportunities during 436.7 hours of surveillance.
The study found substantial variation in hand hygiene opportunities across settings, with estimates ranging from 30 to 179 opportunities per patient-day on inpatient wards and 1.84 to 5.03 per bed-hour in emergency departments. Significant differences emerged between hospital types and among clinical areas, providing important baseline data for the field. These estimates serve as crucial denominators for calculating hand hygiene compliance rates when automated product utilization data are available, addressing a key gap in infection prevention measurement and enabling more accurate assessment of healthcare worker hand hygiene performance without relying solely on direct observation.
