The Particulars: The standard method for monitoring hand hygiene compliance before and after patient contact does not assess the appropriateness or risk stratification of compliance as described in the World Health Organization’s 5 Moments (5M) hand hygiene audit tool. The accuracy of monitoring compliance in prolonged episodes of patient care that involves long “strings” of hand hygiene activity is uncertain.

Data Breakdown: A study compared use of the before-and-after contact method with 5M tools during prospective audits of hand hygiene compliance in two ICUs. The research team assessed overall and per-moment rates of compliance. Overall compliance was significantly over-reported with before-and-after contact method (~9%), when compared with 5M, particularly when episodes included more than three moments. When comparing individual moments, the before-and-after contact method overestimated compliance by 4% (1 moment) to 18% (4 moments).

Take Home Pearl: When compared with 5M tools, before-and-after contact method auditing for hand hygiene compliance appears to significantly overestimate compliance.

References

For more information on these studies and others that were presented at ICAAC 2012, go to www.icaac.org.