Measuring hand hygiene compliance in a hematology-oncology unit: a comparative study of methodologies.

BACKGROUND

In managing hematology-oncology patients, there is a great opportunity for performing hand hygiene (HH).

METHODS

Over a 4-month period, we compared HH compliance measurement by 3 different methods: direct observation, electronic handwash counter for alcohol gel, and measuring the volume of product used (alcohol gel) in a 40-bed hematology-oncology unit at a tertiary care, private hospital.

RESULTS

There were 388 directly observed opportunities for HH, and the overall HH compliance rate was 84.5%. A total of 235,923 HH episodes was recorded by the electronic devices. The mean HH episodes per patient-day was 77.7. There were 91.1 mL of alcohol gel used per patient-day in the unit. The correlation and P value between the percentage of HH compliance and HH episodes per 1,000 patient-days were ρ = 0.442 and P = .076, respectively. The correlation and P value between HH episodes per patient-days and alcohol gel consumption in milliliters per patient-days were ρ = 0.142 and P = .586.

CONCLUSION

HH compliance was high in this unit. Direct observation, although useful, has many drawbacks. Other measures must be considered, such as electronic devices and measurement of volume use per patient-day to stimulate health care workers to increase and sustain HH compliance.