Can hand hygiene observation and reporting be improved through a risk-based targeted approach?

It is well accepted that good hand hygiene practice is important in reducing health care–associated infection and therefore saving lives.Despite the intense research effort that has been undertaken over decades, a level of hand hygiene compliance that results in reduction in health care–associated infection has never been established.The World Health Organization program, My 5 Moments for Hand Hygiene, has resulted in an internationally accepted manner of observation and reporting of hand hygiene compliance.