INTRODUCTION: Hand hygiene(HH) is an important prevention measure for reducing healthcare-associated infections(HAIs), but adherence to HH compliance is suboptimal by healthcare workers(HCWs).

AIM: The aim of this study was to measure the adherence of HH compliance of HCWs and to identify hindrances in non-compliance in a specialized care pediatric hospital in the United States.

METHODS: An observational study of compliance of HH practices among HCWs using the direct observation method was conducted over a two-month period in 2017 at two campuses of a pediatric hospital, by one trained observer. HH opportunities were defined by the World Health Organization’s “Five Moments for Hand Hygiene” and the Clean-in and Clean-out Campaign.

RESULTS: A total of 2236 HH opportunities were observed during the two-month period with a compliance of 75%. HH compliance for both hospitals campuses differed upon entry and exit. Compliance did not vary significantly among hospital units and HCWs. Three barriers to HH compliance by HCWs appeared to be the most frequent; improper use of gloves, frequent entry and exit, and hands full with supplies.

DISCUSSION: The overall HH compliance among HCWs in the study was 76%, which exceeds the average reported compliance rate of 50%. Surveillance of HH is an important infection control policy that should be implemented by doing regular audits with feedback of results in an effort to encourage compliance.