title: Comparison of hand hygiene monitoring using the 5 Moments for Hand Hygiene method versus a wash in-wash out method.
abstract: BACKGROUND
  One strategy to promote improved hand hygiene is to monitor health care workers' adherence to recommended practices and give feedback. For feasibility of monitoring, many health care facilities assess hand hygiene practices on room entry and exit (wash in-wash out). It is not known if the wash in-wash out method is comparable with a more comprehensive approach, such as the World Health Organization's My 5 Moments for Hand Hygiene method.
  
  
  METHODS
  During a 1-month period, a surreptitious observer monitored hand hygiene compliance simultaneously using the wash in-wash out and My 5 Moments for Hand Hygiene methods.
  
  
  RESULTS
  For 283 health care worker room entries, the methods resulted in similar rates of hand hygiene compliance (70% vs 72%, respectively). The wash in-wash out method required 148 hand hygiene events not required by the My 5 Moments for Hand Hygiene method (ie, before and after room entry with no patient or environmental contact) while not providing monitoring for 89 hand hygiene opportunities in patient rooms.
  
  
  CONCLUSIONS
  The monitoring methods resulted in similar overall rates of hand hygiene compliance. Use of the wash in-wash out method should include ongoing education and intermittent assessment of hand hygiene before clean procedures and after body fluid exposure in patient rooms.
authors.affiliation: Infectious Diseases Division, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH; Center for Proteomics and Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, OH.
authors.forename: Venkata C K
authors.initials: VC
authors.lastname: Sunkesula
authors.affiliation: Geriatric Research, Education, and Clinical Center, Cleveland VA Medical Center, Cleveland, OH.
authors.forename: David
authors.initials: D
authors.lastname: Meranda
authors.affiliation: Infectious Diseases Division, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH.
authors.forename: Sirisha
authors.initials: S
authors.lastname: Kundrapu
authors.affiliation: Infection Control Department, Cleveland VA Medical Center, Cleveland, OH.
authors.forename: Trina F
authors.initials: TF
authors.lastname: Zabarsky
authors.affiliation: Infection Control Department, Cleveland VA Medical Center, Cleveland, OH.
authors.forename: Melissa
authors.initials: M
authors.lastname: McKee
authors.affiliation: Microbiology, GOJO Industries, Inc, Akron, OH; Department of Integrative Medical Sciences, Northeastern Ohio Medical University, Rootstown, OH.
authors.forename: David R
authors.initials: DR
authors.lastname: Macinga
authors.affiliation: Infectious Diseases Division, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH; Geriatric Research, Education, and Clinical Center, Cleveland VA Medical Center, Cleveland, OH. Electronic address: curtisd123@yahoo.com.
authors.forename: Curtis J
authors.initials: CJ
authors.lastname: Donskey
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D062665:Epidemiological Monitoring; D019983:Guideline Adherence; D063373:Hand Hygiene / Q000379:methods*; D006801:Humans; D017053:Infection Control / Q000379:methods*
keywords: Compliance; Hand hygiene; My 5 Moments for Hand Hygiene