title: Implementation of directly observed patient hand hygiene for hospitalized patients by hand hygiene ambassadors in Hong Kong.
abstract: The importance of compliance with hand hygiene by patients is increasingly recognized to prevent health care-associated infections.
  
  
  
  This descriptive study observed the effects of an education campaign, targeted to increase patients' self-initiated hand hygiene, and a hand hygiene ambassador-initiated directly observed hand hygiene program on patients' hand hygiene compliance in a university-affiliated hospital.
  
  
  
  The overall audited compliance of patients' self-initiated hand hygiene was only 37.5%, with a rate of 26.9% (112/416 episodes) before meals and medications, 27.5% (19/69 episodes) after using a urinal or bedpan, and 89.7% (87/97 episodes) after attending toilet facilities. Patients referred from a residential care home for older adults had significantly lower hand hygiene compliance (P = .007). Comparatively, the overall audited compliance of ambassador-initiated directly observed hand hygiene was 97.3% (428/440 episodes), which was significantly higher than patients' self-initiated hand hygiene via a patient education program (37.5%, 218/582 episodes, P < .001).
  
  
  
  Directly observed hand hygiene can play an important role in improving compliance with hand hygiene by hospitalized patients.
authors.affiliation: Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
authors.forename: Vincent C C
authors.initials: VC
authors.lastname: Cheng
authors.affiliation: Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
authors.forename: Josepha W M
authors.initials: JW
authors.lastname: Tai
authors.affiliation: Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
authors.forename: W S
authors.initials: WS
authors.lastname: Li
authors.affiliation: School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, China.
authors.forename: P H
authors.initials: PH
authors.lastname: Chau
authors.affiliation: Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
authors.forename: Simon Y C
authors.initials: SY
authors.lastname: So
authors.affiliation: Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
authors.forename: Lisa M W
authors.initials: LM
authors.lastname: Wong
authors.affiliation: Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
authors.forename: Radley H C
authors.initials: RH
authors.lastname: Ching
authors.affiliation: Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
authors.forename: Modissa M L
authors.initials: MM
authors.lastname: Ng
authors.affiliation: Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
authors.forename: Sara K Y
authors.initials: SK
authors.lastname: Ho
authors.affiliation: Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
authors.forename: Doris W Y
authors.initials: DW
authors.lastname: Lee
authors.affiliation: Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
authors.forename: W M
authors.initials: WM
authors.lastname: Lee
authors.affiliation: Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
authors.forename: Sally C Y
authors.initials: SC
authors.lastname: Wong
authors.affiliation: Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China. Electronic address: kyyuen@hkucc.hku.hk.
authors.forename: K Y
authors.initials: KY
authors.lastname: Yuen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000067289:Behavior Observation Techniques / Q000379:methods*; D003428:Cross Infection / Q000517:prevention & control; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D063373:Hand Hygiene / Q000379:methods*; D006723:Hong Kong; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D055815:Young Adult
keywords: Patient hand hygiene; directly observed; hand hygiene ambassador