title: Moment-specific compliance with hand hygiene.
abstract: BACKGROUND
  Hand hygiene is an important component of patient-safety education. The World Health Organization recommends the use of hand hygiene measures at five clinical moments. While previous studies have treated hand hygiene as a single entity, we investigated whether and how the compliance of students may vary across the five clinical moments. We also studied their reasons for non-compliance with a view to inform teaching.
  
  
  METHODS
  A voluntary self-administered questionnaire survey was conducted on a convenient sample of 339 medical and nursing students. The five clinical moments studied were: before touching a patient (moment 1); before a clean/aseptic procedure (moment 2); after body fluid exposure risk (moment 3); after touching a patient (moment 4); and after touching the patient's surroundings (moment 5).
  
  
  RESULTS
  The overall reported compliance rate was 83.0 per cent. The compliance rates were significantly lower at moments 1 and 5. Nursing students reported better overall compliance (p = 0.01), and at moments 2 (p = 0.0001) and 3 (p = 0.0001), than medical students. Medical students fared better at moment 4 (p = 0.009). The most common reason reported for non-compliance was 'forgetfulness'.
  
  
  CONCLUSIONS
  We identified differences in compliance rates across the five clinical moments of hand hygiene. Education programmes should not treat the hand hygiene process as a single entity, but should adopt a moment-specific approach to promote recall, with particular emphases on moments 1 and 5. Nursing and medical students may require different education strategies. Future studies on hand hygiene may also adopt a moment-specific approach.
authors.affiliation: Department of Community Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Lau
authors.forename: Grace
authors.initials: G
authors.lastname: Tang
authors.forename: Ka-lun
authors.initials: KL
authors.lastname: Mak
authors.forename: Gilberto
authors.initials: G
authors.lastname: Leung
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D017408:Guidelines as Topic; D063373:Hand Hygiene; D006801:Humans; D008297:Male; D061214:Patient Safety; D013337:Students, Medical; D013338:Students, Nursing; D014944:World Health Organization