Is it possible to truly observe compliance to WHO's 5 Moments of Hand Hygiene?

The effectiveness of the World Health Organization's My 5 Moments for Hand Hygiene method is well-documented, but a new study published in the American Journal of Infection Control calls into question the feasibility of observing compliance with WHO's M5M.

The study was created to compare the ease of observation of M5M compared to the ease of observing hand hygiene compliance upon room entry and exit. During the multicenter trial, direct observations were made outside patient rooms for privacy protection and to minimize the Hawthorne effect, which suggests hand hygiene compliance improves when subjects believe they are being watched.

The authors of the study found, under covert direct observation, the entry/exit method opportunities were observed at all times, but M5M episodes were only observable 32.3 percent of the time. Furthermore, the ability to observe M5M episodes was even lower in certain wards (roughly 28 percent).

Ultimately, while the M5M method may better approximate hand hygiene effectiveness, the feasibility of directly observing hand hygiene compliance using M5M is limited in U.S. hospitals.

"Physical barriers represent the most significant obstacle in the implementation of M5M methodology," concluded the study authors. "When deciding on a specific observation method, infection prevention programs need to take into account the physical infrastructure of their hospital to maximize the utility of their hand hygiene compliance monitoring efforts."

 

 

 

More articles on hand hygiene:
CDC's 3-step hand-washing technique vs. WHO's 6-step technique: Which is most effective?
Quality improvement, hand hygiene initiatives needed in outpatient settings, study finds
Nurses face three times as many hand hygiene opportunities as physicians, study finds


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