title: Hand hygiene compliance: exploring variations in practice between hospitals.
abstract: BACKGROUND
  The issue of 'centre' or 'hospital' as an independent variable has not been studied extensively in healthcare workers' hand-hygiene practices.
  
  
  OBJECTIVE
  To investigate healthcare workers' compliance with hand-hygiene guidelines in four acute-care hospitals in Ireland and to examine factors that contributed to non-compliance.
  
  
  METHODS
  Data collectors observed healthcare workers in four hospitals.
  
  
  RESULTS
  Data (n = 1,737 observations) was drawn from a random sample of nurses, doctors, physiotherapists and HCAs (n = 280 staff). Findings revealed that the individual hospital has a significant impact. Multivariate logistic regression analysis showed healthcare workers in centre 4 had a significantly higher likelihood of non-compliance than those in all other centres (p = 0.003), irrespective of gender, discipline or area of work.
  
  
  CONCLUSIONS
  The findings make an important contribution to the study of healthcare workers' hand-hygiene behaviour and control of healthcare-associated infections. A possible explanation of the results may be related to variations in organisational support and hospital culture.
authors.affiliation: School of Nursing and Midwifery, University College Cork, Ireland.
authors.forename: Sile A
authors.initials: SA
authors.lastname: Creedon
mesh_terms: D000208:Acute Disease / Q000628:therapy; D001291:Attitude of Health Personnel; D054869:Clinical Audit; D002983:Clinical Competence / Q000592:standards; D015987:Effect Modifier, Epidemiologic; D019983:Guideline Adherence / Q000592:standards*; D006235:Hand Disinfection / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006742:Hospital Bed Capacity; D006769:Hospitals, General; D006801:Humans; D007494:Ireland; D016015:Logistic Models; D015999:Multivariate Analysis; D015403:Nursing Evaluation Research; D009790:Occupations; D010564:Personnel, Hospital / Q000193:education / Q000523:psychology / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards*; D011795:Surveys and Questionnaires