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Hand hygiene compliance on two icus at hannover medical school: indication-specific analysis of compliance rates per bedside


Health care-associated infections (HAIs) are a major problem on intensive care units (ICUs) [1]. Hand hygiene (HH) is considered to be the most important tool to prevent HAIs. The aim of this study was to generate indication-specific HH compliance focusing aseptic procedures (AP).


hand hygiene compliance, aseptic procedures.


For a period of 2 weeks direct bedside observation (BO) was performed on a surgical ICU and a medical ICU in accordance to the WHO guideline “my 5 moments for hand hygiene” [2]: (1) “before contact with patients”, (2) before an AP”, (3) “after body fluid exposure”, (4) “after contact with patients”, and (5) “after contact with patients’ surroundings”. BO of HCW were performed from 7:00am to 7:00pm 3 days a week. AP were stratified into manipulation of ventilation devices (VD), intravascular catheters (IC), urinary catheters (UC), dressing (D), and other AP.


During the 144 hour observation period, a total of 1,896 opportunities for HH were observed for the two ICUs. The indication (2) was the most commonly observed indication (28.3%; n=537; see Fig.1). The overall HH compliance rate (CR) was 42.6%. The highest CR was evaluated for indication (4) (66.4%), whereas lowest CR was calculated for indication (2) (24.8%; see Fig. 2). Stratifying the AP into the different device manipulations described below revealed that “manipulation of IC” was the most frequently observed AP but only reached low CR (24.2%; n=293). The highest CR was evaluated for “manipulations of UC” (42.9%; n=14). In contrast lowest CR was observed with “manipulation of VD” (18.7%; n=134; see table 1).


The overall CR per bedside was poor particularly with indication (2). Thus, future interventions to improve HCWs adherence to HH and therefore patients’ safety should focus on AP.

Disclosure of interest

None declared.


  1. Beyersmann J, et al: Nosocomial infection, length of stay, and time-dependent bias. Infect Control HospEpidemiol. 2009, 30: 273-6. 10.1086/596020.

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  2. WHO: WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care is Safer Care. 2009, []

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Schwadtke, L., Krauth, C., Stahmeyer, J. et al. Hand hygiene compliance on two icus at hannover medical school: indication-specific analysis of compliance rates per bedside. Antimicrob Resist Infect Control 4 (Suppl 1), P157 (2015).

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