Compliance with hand hygiene in intensive care units

Introduction: Nosocomial infections are an important problem in modern hosp itals. The prevalence in German intensive care units is 15.3%. Hand washing or hand disinfection is believed to be the most important means of prevent ing nosocomial infections. We wished to answer the following questions: 1. How good is the compliance of hand hygiene on intensive care units? 2. Is c ompliance associated with the patient/nurse-ratio? Method: In a study of 8 intensive care units the compliance of hand hygiene was observed on two occasions, once in May 1996 and again in November 1997 . The prime necessity for hand disinfection occurred when handling ventilat ion devices, intravascular catheters, urinary catheters and dressings. In a ddition the patient/nurse-ratio was calculated. Results: A total of 1,879 infection-relevant handlings were observed. The c ompliance of hand hygiene ranged from 25.7 to 83.2% (mean 55.2%). The most commonly observed handlings were the manipulation of venous catheters (52.7 %), the highest compliance was observed with the manipulation of ventilatio n equipment (91.8%). With a better patient nurse ratio the compliance did n ot improve but remained the same or was even reduced. Discussion: The compliance of hand disinfection is similar to other study r esults, but on some intensive care units there was considerable room for im provement. In this study the compliance of hand hygiene is more of a consta nt factor in individual intensive care units than associated with the patie nt/nurse-ratio.