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Across the globe, hand hygiene (HH) is promoted to fight the spread of healthcare associated infections. Despite multiple ongoing HH campaigns and projects, the healthcare associated infection rates remain high especially in low- and middle-income countries. In the narrative overview presented here, we aim to share objectives, framework, successes and challenges of our long-term partnership in Guinea to offer guidance for other projects aiming to sustainably improve HH.

Objectives: The purpose of this study was to compare methods for assessing compliance with hand hygiene in an intensive care unit (ICU), a step-down unit (SDU), and a hematology–oncology unit. Methods: Over a 20-week period, we compared hand hygiene compliance measurements by three different methods: direct observation, electronic handwash counter for alcohol gel, and measuring the volume of product used (alcohol gel) in an ICU, an SDU, and a hematology–oncology unit of a tertiary care, private hospital. Results: By direct observation we evaluated 1078 opportunities in the ICU, 1075 in the SDU, and 517 in the hematology–oncology unit, with compliance rates of 70.7%, 75.4%, and 73.3%, respectively. A total of 342 299, 235 914, and 248 698 hand hygiene episodes were recorded by the electronic devices in the ICU, SDU, and hematology–oncology unit, respectively. There were also 127.2 ml, 85.3 ml, and 67.6 ml of alcohol gel used per patient-day in these units. We could find no correlation between the three methods. Conclusions: Hand hygiene compliance was reasonably high in these units, as measured by direct observation. However, a lack of correlation with results obtained by other methodologies brings into question the validity of direct observation results, and suggests that periodic audits using other methods may be needed.

Objectives: The purpose of this study was to compare methods for assessing compliance with hand hygiene in an intensive care unit (ICU), a step-down unit (SDU), and a hematology-oncology unit., Methods: Over a 20-week period, we compared hand hygiene compliance measurements by three different methods: direct observation, electronic handwash counter for alcohol gel, and measuring the volume of product used (alcohol gel) in an ICU, an SDU, and a hematology-oncology unit of a tertiary care, private hospital., Results: By direct observation we evaluated 1078 opportunities in the ICU, 1075 in the SDU, and 517 in the hematology-oncology unit, with compliance rates of 70.7%, 75.4%, and 73.3%, respectively. A total of 342,299, 235,914, and 248,698 hand hygiene episodes were recorded by the electronic devices in the ICU, SDU, and hematology-oncology unit, respectively. There were also 127.2 ml, 85.3 ml, and 67.6 ml of alcohol gel used per patient-day in these units. We could find no correlation between the three methods., Conclusions: Hand hygiene compliance was reasonably high in these units, as measured by direct observation. However, a lack of correlation with results obtained by other methodologies brings into question the validity of direct observation results, and suggests that periodic audits using other methods may be needed., (Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.)