Following guidelines for hand hygiene can help decrease hospital-acquired infections, yet compliance rates among health care providers are low. Erasmus and colleagues examined 96 studies on hand hygiene in the hospital setting. The studies found overall compliance rates for hand hygiene (the percentage of opportunities to adhere to hygiene guidelines) ranging from 4% to 100%. Studies showed lower compliance rates in ICUs (40% to 50%) than in other hospital settings (50% to 60%). Moreover, 35 studies looked at compliance rates before and after patient contact and found a median compliance rate of 21% before contact versus 47% after.

In general, compliance was lower among physicians (32%) than nurses (48%). Eight studies included examination of alcohol-based rubs and found them to be positively related to compliance.

The authors noted that the methods of these 96 studies were, in general, lacking or incompletely reported. As a group, the studies revealed low compliance with hand hygiene guidelines, with variability according to the type of health care worker and the situation.

The authors suggest that more research and standardized measurement and guidelines for hand hygiene are needed.