Healthcare Infection Prevention

Hand hygiene rarely observed in LTC

A meager 15% compliance rate

Adherence to hand hygiene in long-term care facilities is "alarmingly low," investigators reported recently in Chicago at the annual meeting of the Society for Healthcare Epidemiology of America.1 While hospital hand hygiene compliance rates typical hover around the 50% rate, the researchers found a shockingly low 15% compliance rate in two Canadian long-term care settings.

Noting that little is known about adherence to hand hygiene among health care workers in long-term care facilities, they conducted a prospective cohort study in two Hamilton, Ontario, long-term care facilities. There were a total of 538 residents and 17 resident care units in the study. For each unit, they randomly selected six 20-minute periods where a trained observer assessed adherence during staff-resident opportunities for hand hygiene.

Health care workers were observed from the start of the interaction until either use of a hand hygiene product (soap or antibacterial alcohol gel) or interaction with a different patient. The type of health care worker activity, use of protective barriers, and duration of hand hygiene was recorded. Overall, 490 hand hygiene opportunities were observed. The overall average rate of adherence was a dismal 14.7% (14.3% in one facility and 15.1% in the other).


  1. Smith A, Loeb M. Adherence to hand hygiene among healthcare workers in long-term care facilities. Abstract 240. Society for Healthcare Epidemiology of America. Chicago; March 18-21, 2006.