BACKGROUND: While hand hygiene is recognized as the cornerstone for reducing risk for nosocomial infections, compliance in our institution remains low. Previously identified barriers include poor access to hand hygiene products, lack of reminders, and poor knowledge on indications.

METHODS: At the medical wards and ICU of a tertiary hospital, a group of medical students, residents, and nurses was exposed to interventions addressing the identified barriers. Alcohol handrub was provided at each bedside, visual reminders were placed at critical locations, and commonly missed opportunities were reinforced at the start of the study. Hand hygiene compliance was covertly evaluated after two weeks and compared against that of an unexposed group.

RESULTS: 664 and 727 hand hygiene opportunities were observed in the unexposed and exposed groups, respectively. Compliance was higher in the exposed group (32.60% vs. 16.26%, p <0.05), which by subset analysis was consistent for the different healthcare worker designations and locations evaluated. Nurses had the highest compliance rate in both groups.

CONCLUSIONS: These results suggest the efficacy of the employed interventions in improving hand hygiene compliance in this setting. Hand hygiene opportunities identified to be most frequently missed in this observation can guide future intervention efforts in our institution.