Quantifying the Hawthorne Effect in Hand Hygiene Compliance Through Comparing Direct Observation With Automated Hand Hygiene Monitoring.

In this prospective observational study, hand hygiene compliance was assessed using two methods: a system of 70 electronic dispensers with a counter that registered when and how often each dispenser was activated, and a trained study assistant who observed hand disinfection procedures for 2 hours per shift. A total of 3,978 situations requiring hand disinfection according to the '5 Moments' model (WHO) were observed. In 2,034 of these cases, healthcare workers actually disinfected their hands. The compliance rate was 51%. A comparison of the electronically recorded data from the remaining 6 hours of the shift without direct observation with the data from the observation period showed that the number of hand disinfections decreased to 8 per hour compared with 21 during the observation period.

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