Compliance with hand hygiene and glove change in a general hospital, Mashhad, Iran: An observational study

Background: Hand hygiene is the single most important element of strategies to prevent health care-associated infections. However, handwashing rates among health care workers have ranged from 9% to 50%. This observation took place as a structured, overt strategy to assess the hospital staff's hand hygiene compliance. The study was carried out in Imam Reza General Hospital, Mashhad, Iran. Methods: All hospital staff, including physicians, nurses, and unlicensed assistive personnel in 4 randomly selected wards, were observed by 2 infection control nurse specialists for 5 observation periods on each ward. The observation was overt, and observers compiled data by filling out 2 checklists. All staff knew that they were being observed, and the observers made no interventions. Results: The overall compliance with hand hygiene activities was 47.9% (438 episodes out of 913 potential opportunities) and, with sole emphasis on handwashing, was only 8.5%. Conclusion: Inappropriate glove use might be a component of poor hand hygiene compliance. Training campaigns should be implanted for health care personnel and all hospital staff to re-emphasize the importance of adherence to hand hygiene protocols.