Hand hygiene during the intensive care unit ward round: how much is enough? An observational study

Hand hygiene is the single most important measure to prevent transmission of infection, yet clinicians find it difficult to comply. We assessed the hand hygiene compliance of an individual intensivist.

Observational study at Southern Health, Melbourne, VIC.

Compliance with hand hygiene opportunities during four consecutive 1-hour periods (three in the intensive care unit, one during a medical ward round).

The subject had contact with 21 patients during the 4 hours, generating 76 hand hygiene opportunities. He completed hand hygiene 33 times, an average of once every 9 minutes and a compliance of 43%.

Despite the subject's best intentions, hand hygiene was inadequate. The manner in which clinicians practise in the ICU, examine patients and conduct ward rounds needs to be reconsidered in the light of these results.