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

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

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.

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.

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.