title: [Compliance with hand hygiene guidelines on intensive care units at a university medical centre with surgical focus].
abstract: OBJECTIVE
  Hand hygiene practice is one of the most effective measures to prevent healthcare-associated infections. This study examines the trends of hand hygiene compliance among physicians and nurses on the intensive care units (ICU) and hematopoetic stem cell transplantation units (HSCTU) at Hannover Medical School. An observational study via repeated cross-sectional assessments was conducted during the first 6 years of the "AKTION Saubere Hände" (ASH), i.e. the German adaptation of WHO's "Clean Care is Safer Care" campaign.
  
  
  METHODS
  Compliance rates were directly observed in accordance with WHO definitions on the 10 ICU and two HSCTU. Overall, 13,175 hand hygiene opportunities were observed between 2008 and 2013.
  
  
  RESULTS
  In 2008, compliance rates of physicians and nurses did not differ significantly in statistical terms (53% vs. 57%, p=0.085). Physicians' compliance improved to 64% in 2011, but declined again to 48.4% in 2013 (p < 0.001). In contrast, hand hygiene compliance among nurses had increased to 71.3% as soon as 2009 /10 (p < 0.001). Their compliance dropped to 55.8% in 2013 and thus to baseline level (p=0.444), while remaining higher than that of physicians (p=0.003). Similar trends pertained to the surgical ICU.
  
  
  CONCLUSIONS
  These results indicate that during the ASH-campaign hand hygiene compliance increased initially both among physicians and nurses, albeit so far not in a sustainable fashion. This implies an increased demand for interventions which not only promote motivation, but also its translation into stable and sustained behavior in accordance with guidelines.
authors.affiliation: Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule Hannover.
authors.forename: L
authors.initials: L
authors.lastname: Schwadtke
authors.affiliation: Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule Hannover.
authors.forename: K
authors.initials: K
authors.lastname: Graf
authors.affiliation: Forschungs- und Lehreinheit Medizinische Psychologie, Medizinische Hochschule Hannover.
authors.forename: B
authors.initials: B
authors.lastname: Lutze
authors.affiliation: Forschungs- und Lehreinheit Medizinische Psychologie, Medizinische Hochschule Hannover.
authors.forename: T
authors.initials: T
authors.lastname: von Lengerke
authors.affiliation: Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule Hannover.
authors.forename: I F
authors.initials: IF
authors.lastname: Chaberny
mesh_terms: D000046:Academic Medical Centers / Q000592:standards* / Q000706:statistics & numerical data; D005858:Germany; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D063373:Hand Hygiene / Q000592:standards* / Q000706:statistics & numerical data; D007362:Intensive Care Units / Q000592:standards* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D057184:Practice Patterns, Nurses' / Q000592:standards / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D013503:Surgery Department, Hospital / Q000592:standards / Q000706:statistics & numerical data