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Hand hygiene (HH) has been considered as the single most effective measure for preventing and controlling healthcare-associated infections. Although there are several reports on compliance rates to HH recommendations, data for appropriate observation numbers to determine HH compliance are limited. 방법 The current study was conducted at a referral hospital from January 2018 to December 2018. We monitored HH by direct observation. The HH compliance rate was calculated by dividing the number of observed HH actions by the total number of opportunities. Appropriate HH compliance rates were calculated based on the 6-step technique, modified from the WHO recommendation. The minimum number of required observations (n) was calculated by the following equation using overall mean value (ρ), margin of error (ME) and confidence interval (CI, α) [The equation: n≥Z_(α/2)^2 x ρ^2 x (1- ρ)^2/ME^2]. We considered 5%, 10%, 15%, and 20% for MEs, and CIs were set to 99%, 95%, and 90%, respectively. 결과 During the study period, 8,791 opportunities among 1,168 healthcare workers were monitored. Mean HH compliance and appropriate HH compliance rates were 80.3% and 59.7%, respectively. Minimum number of required observations for determining HH compliance ranged from 11 (ME 20%, CI 90%) to 419 (ME 5%, CI 99%); whereas, for appropriate HH compliance, it ranged from 16 (ME 20%, CI 90%) to 638 (ME 5%, CI 99%)(Figure 1). 결론 Minimum number of observations required to determine HH compliance and appropriate HH compliance was 11 and 16, respectively, with 20% ME, 90% CI. To our knowledge, this study provides the first data picturing the appropriate number of observations for determining HH compliance. [ABSTRACT FROM AUTHOR]