Table 2.

Recent publications on hand hygiene (HH) programmes and reported methods of monitoring of HH compliance

Reference	Involved sites	Method of hand hygiene compliance surveillance or other outcome measures	Direct observation method (if used)
Allegranzi et al. [5▪▪]	Six pilot sites across Costa Rica, Italy, Mali, Pakistan and Saudi Arabia	Direct observation	5 Moments
		Questionnaire on knowledge of health care workers
Allegranzi et al. [9▪]	168 facilities across the USA	76.1% direct observation at least every 3 months	Primarily room entry and exit although numbers not specified
		39.8% ABHR consumption
		34.1% soap consumption
Fuller et al. [32]	16 acute hospitals in England and Wales	Direct observation	Hand Hygiene Observation Tool (HHOT) [41]
		Consumption of hand hygiene products
Grayson et al. [17]	National programme in Australia	Direct observation	5 Moments
Jarlier et al. [19]	38 teaching hospitals in France	Consumption of hand hygiene products
Kirkland et al. [28]	Single centre in the USA	Direct observation	‘Before-and-after contact with patients or their immediate environments’
Latham et al. [11▪]	Evaluations of 18 hand hygiene campaigns across the European Union and European Economic Area Member States	70% direct observation	Not specified
		33% consumption of HH products
		10% availability of ABHR
		10% questionnaire
		20% self assessment survey
Reichardt et al. [42▪]	German national programme	Direct observation in 180 of >700 hospitals	5 Moments
		Consumption of hand hygiene products
Reisinger et al. [43]	Veterans Health Administration encompassing 141 medical centres in the USA	98.6% direct observation	A variety of moments observed, most often room entry and exit
		22.7% consumption of hand hygiene products	41.4% reported monitoring ‘5 Moments’ in addition to other opportunities
		2.8% automated monitoring systems
Salmon et al. [44]	Single centre in Vietnam	Direct observation
		Consumption of hand hygiene products
Stone et al. [18]	187 acute trusts in England and Wales	Consumption of hand hygiene products
Schweizer et al. [30▪▪]	Meta analysis of 45 hand hygiene intervention bundles worldwide	86.6% direct observation	Variety of methods utilized most commonly ‘5 Moments’, room entry and exit, before and after patient contact, or unspecified
		13.3% consumption of hand hygiene products
		4.4 % video surveillance
		11.1% automated monitoring systems
Szilagyi et al. [45]	Single centre in Singapore	Evaluation of HH technique

ABHR, alcohol-based hand rub.