title: Measuring hand hygiene compliance in a hematology-oncology unit: a comparative study of methodologies.
abstract: BACKGROUND
  In managing hematology-oncology patients, there is a great opportunity for performing hand hygiene (HH).
  
  
  METHODS
  Over a 4-month period, we compared HH compliance measurement by 3 different methods: direct observation, electronic handwash counter for alcohol gel, and measuring the volume of product used (alcohol gel) in a 40-bed hematology-oncology unit at a tertiary care, private hospital.
  
  
  RESULTS
  There were 388 directly observed opportunities for HH, and the overall HH compliance rate was 84.5%. A total of 235,923 HH episodes was recorded by the electronic devices. The mean HH episodes per patient-day was 77.7. There were 91.1 mL of alcohol gel used per patient-day in the unit. The correlation and P value between the percentage of HH compliance and HH episodes per 1,000 patient-days were ρ = 0.442 and P = .076, respectively. The correlation and P value between HH episodes per patient-days and alcohol gel consumption in milliliters per patient-days were ρ = 0.142 and P = .586.
  
  
  CONCLUSIONS
  HH compliance was high in this unit. Direct observation, although useful, has many drawbacks. Other measures must be considered, such as electronic devices and measurement of volume use per patient-day to stimulate health care workers to increase and sustain HH compliance.
authors.affiliation: Onco-Hematology Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: Lidiane Soares
authors.initials: LS
authors.lastname: Sodré da Costa
authors.forename: Vanessa Maia
authors.initials: VM
authors.lastname: Neves
authors.forename: Alexandre R
authors.initials: AR
authors.lastname: Marra
authors.forename: Thiago Zinsly
authors.initials: TZ
authors.lastname: Sampaio Camargo
authors.forename: Maria
authors.initials: M
authors.lastname: Fátima dos Santos Cardoso
authors.forename: Elivane
authors.initials: E
authors.lastname: da Silva Victor
authors.forename: Cristina
authors.initials: C
authors.lastname: Vogel
authors.forename: Fátima Araci
authors.initials: FA
authors.lastname: Tahira Colman
authors.forename: Claudia Regina
authors.initials: CR
authors.lastname: Laselva
authors.forename: Oscar Fernando
authors.initials: OF
authors.lastname: Pavão dos Santos
authors.forename: Michael B
authors.initials: MB
authors.lastname: Edmond
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D003625:Data Collection / Q000379:methods*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D063373:Hand Hygiene; D006302:Health Services Research / Q000379:methods*; D019337:Hematologic Neoplasms; D006757:Hospital Units; D006801:Humans
keywords: Compliance; Direct observation; Electronic handwash counters; Patient safety