Evaluation of the number of opportunities for hand hygiene in hospital: A new methodological approach

To assess the number of alcohol-based hand rubbing (ABHR) opportunities in different wards of a university hospital. The amount of care procedures was measured in nine wards (4 medical wards, 4 surgical wards, 1 intensive care unit) over a two-year period. We converted the number of care procedures into a number of ABHR opportunities using the definition provided by the World Health Organization that takes in account the nature of the care procedure and the number of healthcare workers involved in. We compared these data with those obtained by other authors and the theoretical minimal number of ABHR opportunities defined by the French Ministry of Health. 1,252,671 care procedures (with a mean period of 734days/department, 122,866 days of hospitalization and 21,905 patients) were converted into ABHR opportunities. The mean number of care procedures and ABHR per day and per patient was 6.1 and 35 for the medical departments, 7.6 and 49 for the surgery departments, 14.8 and 237 for the intensive care unit, respectively. Our methodological approach strengthens the results of previous observational studies. Here, we showed that the number of ABHR opportunities is far higher than that defined by the French Ministry of Health to measure the hand hygiene hospital endeavour.