Hand hygiene practices of home visiting community nurses: perceptions, compliance, techniques, and contextual factors of practice using the World Health Organization's "five moments for hand hygiene".

In this observational study, the perceptions, compliance, techniques, and contextual issues of hand hygiene practices among community clinicians (nurses) during 103 hand hygiene opportunities (based on the World Health Organization "Five Moments for Hand Hygiene") in 40 patient care episodes were examined. Compliance with standard hand hygiene practices was generally poor, with many contextual influences making compliance difficult. Clinician preferences and convenience are important considerations in hand hygiene compliance. Improving home-visiting community clinicians' hand hygiene practices requires addressing contextual issues related to the availability of hand hygiene equipment, such as alcohol-based hand rubs, as well as hand hygiene in-service education to update knowledge on hand hygiene for everyday practice in community settings.