Observer Role Impacts Directly Observed Hand Hygiene Compliance on Medical-Surgical Units

BACKGROUND: In our 713-bed academic tertiary care center, hand hygiene (HH) measurement was previously calculated by product usage corrected for patient census, validated by direct observation data by independent observers from Infection Control/Hospital Epidemiology (ICHE). In 2014, product usage estimates on inpatient medical-surgical units were replaced by direct observations performed by unit-based observers from Patient Care Services (PCS). We sought to compare HH compliance between ICHE and PCS observers to ensure accuracy of PCS-collected data.