Rate of Healthcare Worker–Patient Interaction and Hand Hygiene Opportunities in an Acute Care Setting

Objective. Identify factors affecting the rate of hand hygiene opportunities in an acute care hospital.Design. Prospective observational study.Setting. Medical and surgical in-patient units, medical-surgical intensive care unit (MSICU), neonatal intensive care unit (NICU), and emergency department (ED) of an academic acute care hospital from May to August, 2012.Participants. Healthcare workers.Methods. One-hour patient-based observations measured patient interactions and hand hygiene opportunities as defined by the “Four Moments for Hand Hygiene.” Rates of patient interactions and hand hygiene opportunities per patient-hour were calculated, examining variation by room type, healthcare worker type, and time of day.Results. During 257 hours of observation, 948 healthcare worker–patient interactions and 1,605 hand hygiene opportunities were identified. Moments 1, 2, 3, and 4 comprised 42%, 10%, 9%, and 39% of hand hygiene opportunities. Nurses contributed 77% of opportunities, physicians contributed 8%, othe...