Since hand hygiene surveillance that involves direct observation can be limited by the Hawthorne effect, limiting how long observation periods last could improve the validity of hand hygiene observation, according to a study in Infection Control and Hospital Epidemiology.
The Hawthorne effect is the phenomenon of people changing their behavior when they know they are being observed. For this study, researchers wanted to statistically determine if the Hawthorne effect is stable over a certain observation period.
To do so, trained observers monitored hand hygiene compliance in five intensive care units and six medical/surgical wards in three hospitals in fixed one-hour periods.
They found exit hand hygiene compliance increased after 14 minutes of observation, from 56.2 percent to 60.5 percent. Compliance further increased after 50 minutes, from 60.5 percent to 66 percent. Entry hand hygiene compliance increased from 40.4 percent to 43.4 percent after 38 minutes.
Researchers concluded that limiting direct observation periods to about 15 minutes will minimize the Hawthorne effect and "would be expected to improve the validity of hand hygiene surveillance programs," according to the study.