title: Impact of a hand hygiene audit on hand hygiene compliance in a tertiary care public sector teaching hospital in South India.
abstract: BACKGROUND
  Hand hygiene (HH) practice is considered the most simple, cost-effective, and efficient way to prevent device-associated infections. Continuous auditing plays a vital role in the conversion of HH knowledge into practice.
  
  
  METHODS
  An HH audit was carried out October 2015-September 2016 in 18 locations for a total of 1,080 observation periods and 64,800 minutes of observation. HH complete adherence rate (HHCAR) and HH partial adherence rate were analyzed.
  
  
  RESULTS
  The HHCAR, HH partial adherence rate, and nonadherence rate were 45.5%, 21.17%, and 33.3%, respectively. There was gradual statistically significant increase in monthly HHCAR during the study period from 37.5%-51.7% (P = .001). HHCAR was found to be highest among nurses (58.9%) followed by other staff (46.7%) and doctors (46.6%). World Health Organization Moments 3 and 4 had statistically significant compliance (78.5% and 71.8%, respectively; P < .001) compared with Moments 1, 2, and 5. As the HHCAR increases there is statistically significant decrease in device-associated infection rate from 10.6-3.9 per 1,000 device days (P = .042).
  
  
  CONCLUSIONS
  HH audit has a significant influence on HH compliance. More emphasis needs to be given on compliance with HH practice by doctors and with the World Health Organization "before" Moments, especially. HH audits should be a part of the infection control manual of every hospital.
authors.affiliation: Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. Electronic address: drapurbasastry@gmail.com.
authors.forename: Apurba Sankar
authors.initials: AS
authors.lastname: Sastry
authors.affiliation: Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
authors.forename: Deepashree
authors.initials: D
authors.lastname: R
authors.affiliation: Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
authors.forename: Prasanna
authors.initials: P
authors.lastname: Bhat
mesh_terms: D003428:Cross Infection / Q000517:prevention & control; D004203:Disinfection / Q000379:methods* / Q000706:statistics & numerical data*; D019983:Guideline Adherence; D063373:Hand Hygiene / Q000379:methods*; D006784:Hospitals, Teaching; D006801:Humans; D007194:India; D009731:Nursing Audit / Q000706:statistics & numerical data*; D011446:Prospective Studies; D017150:Public Sector; D062606:Tertiary Care Centers
keywords: Device-associated infections; Hand hygiene complete adherence rate; Hand hygiene partial adherence rate