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Hand Hygiene Compliance and Nurse-Patient Ratio Using Videotaping and Self Report

Hassan, Zeinab M. RN, PhD*; Pryor, Erica R. RN, PhD; Autrey, Pamela S. RN, PhD; Turner, Joan G. RN, DSN

Infectious Diseases in Clinical Practice: July 2009 - Volume 17 - Issue 4 - p 243-247
doi: 10.1097/IPC.0b013e318195e1bf
Original Articles

Background: Appropriately implemented, hand hygiene can prevent nosocomial infections, but there is a lack of research on the effect of specific nurse-patient ratios on hand hygiene compliance rates. Furthermore, there have been few studies of infection control practices in Jordanian hospitals.

Methods: One hundred registered nurses from a private health care setting in Jordan who worked in intensive care units and medical-surgical wards participated. Two methods, videotaping and self-report, were used to collect data on hand hygiene. Subjects also completed a questionnaire to assess hand hygiene behavior, attitudes, and beliefs.

Results: The overall hand hygiene compliance rate was 32%. Nurse-patient ratios affected hand hygiene before beginning patient care only. The lowest hand hygiene compliance rates were in intensive care units when the nurse-patient ratio was less than 1:2. Females had higher compliance rates than males.

Conclusions The observed low level of overall hand hygiene compliance, lower compliance rates in higher acuity settings, and gender-related differences in compliance are consistent with findings from previous studies of hand hygiene over the past 2 decades.

From the *School of Nursing, Hashemite University, Zarqa, Jordan and †School of Nursing, University of Alabama at Birmingham, Birmingham, AL.

Reprints: Zeinab M. Hassan, RN, PhD, PO Box 150459, Zarqa 13115, Jordan. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.