Improvements in hand hygiene across New South Wales public hospitals: Clean hands save lives, Part III

Objective: To describe improvements in hand hygiene compliance after a statewide hand hygiene campaign conducted in New South Wales public hospitals. Design and setting: The campaign was conducted in all area health services in NSW (covering all 208 public hospitals). Alcohol‐based hand rub (AHR) was introduced into all hospitals between March and June 2006. In each hospital, five overt observation surveys of hand hygiene compliance by health care workers (HCWs) were conducted: one pre‐implementation survey and four post‐implementation surveys (in August 2006, November 2006, February 2007 and July 2008). Main outcome measures: Overtly observed hand hygiene compliance rates by HCWs, stratified by before‐ and after‐patient contact, Fulkerson's contact risk categories, and four health care professional groupings. Results: The overall hand hygiene compliance rate improved from 47% before the intervention to an average of 61% over the last three observation periods (P