Assessing nurses' hand decontamination performance

There have been numerous attempts to assess the frequency and technique of nurses' hand decontamination, but criteria employed to define acceptable levels of practice are questionable, while comparisons between staff in different clinical settings appear never to have been undertaken. In the study reported here tight criteria were developed to evaluate performance, then used to compare nurses employed in three clinical settings: intensive care, surgical and medical units. Two hospitals were employed, one with an infection control nurse, the other without. Frequency was highest in the ICU of the second hospital, but technique was superior in ICUs regardless of hospital. Half of all opportunities for essential decontamination were, however, omitted. Technique appeared superior to earlier reports. Alcoholic hand-rub was readily available and used more often in the unit where the best practice was witnessed.