Frequently asked questions about hand hygiene compliance

Hand hygiene involves everyone in the hospital, including patients. Hand cleaning is one of the best ways you and your health care team can prevent the spread of many infections. Patients and their visitors should also practice good hand hygiene before and after entering patient rooms.

More information is available at:

•  Ministry of Health and Long Term Care - Patient Safety  
• Public Health Ontario - Just Clean Your Hands campaign

KGH works hard-to create a culture of patient safety involves everyone – health care administration, health -care professionals, and, of course, patients and families. If low hand hygiene compliance rates are identified, we will review infection prevention and control practices to ensure that they align with best practices documents, as well as the Just Clean Your Hands program and introduce educational interventions and make appropriate revisions to our program.

For the purpose of public reporting, data will be reported on an annual basis. The decision was made to report annually so that hospitals were able to submit enough data and that the compliance rate was statistically valid.

Patients should know that their hospital is safe, that the care they receive is topnotch, and that every effort is made to ensure the highest quality of care possible. Public reporting of hand hygiene compliance rates is another helpful measure to ensure the care provided to Ontario patients is even safer, and continues to improve over time. 

A low reported compliance rate does not necessarily mean that health care providers are not performing hand hygiene. The audit tool measures whether health care providers are performing hand hygiene at the right times and the right way. That is why it is vital that hand hygiene compliance rates are viewed in the context of other performance indicators. That said, the analysis of these rates, over time will certainly provide helpful information that can be used to make system improvements in each hospital.

No. Patient safety is a number one priority for all Ontario hospitals. There are numerous checks and balances in place to ensure the safety of public hospitals but hospital care is complicated and depends on many factors. The public reporting of hospitals’ hand hygiene compliance rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Rates can vary from hospital to hospital, month to month. Some hospitals will have lower observation opportunities because they do not have as much direct provider-to-patient care opportunities. Due to the types and patient populations (i.e. mental health) of these hospitals, their rates may seem lower. Like other indicators, it is important to look at hand hygiene compliance rates in a broader context. The rates must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination.

Health care providers performing hand hygiene is a practice that continues to improve as we learn more about hand hygiene best practices. Both hospitals and the health care system have invested considerable resources to improve hand hygiene in hospitals.

The Public Health Ontario provincial hand hygiene campaign, Just Clean Your Hands, was designed to help hospitals and individuals overcome barriers to proper hand hygiene and improve compliance with hand hygiene best practices. The program recognizes that health care providers are busy and require immediate access to hand hygiene products at the right time in the patient care process.

At KGH, for example, where sinks used to be located inconveniently throughout hospitals, there is now fast and easy access to more than 2,200 alcohol-based hand rubs outside all inpatient rooms and adjacent to patients’ bedsides. There are also more freestanding hand cleaning stations located at all main entrances. In addition, ongoing education sessions are held to ensure health care providers know when and where to clean their hands to ensure patient safety.

Direct observation of hand hygiene practice is done by trained observers using the provincial audit tool. The observer conducts observations openly, recording what they see, with the identity of the health care provider is kept confidential.

The single most common transmission of healthcare-associated infections in a health care setting is via the hands of health care providers.

Health care providers acquire germs from contact with infected patients, or after handling contaminated material or equipment. Hand hygiene is an important practice for health care providers but also involves everyone in the hospital, including patients, families and visitors.

Effective hand hygiene practices in hospitals play a key role in improving patient and health care worker safety, and in preventing the spread of healthcare-associated infections.

Hand hygiene is the removal of visible soil and removal or killing of microorganisms from the hands. This can be accomplished using soap and water for visibly soiled hands or an alcohol-based hand rub.