Hand hygiene compliance monitoring: the state of the art.

Hand hygiene is crucial to prevent transmission of hospital-acquired infections. The WHO recommends five moments for hand hygiene: (1) before patient contact, (2) before performing an aseptic task, (3) after exposure with body fluids, (4) after patient contact, and (5) after contact with patient's surroundings. Nevertheless, hand hygiene compliance rates remain low among healthcare workers. Direct observation is the gold standard method for hand hygiene monitoring; however, it is time consuming and observer dependent. Technology has allowed the development of several other hand hygiene surveillance methods. In this article, we review the different modalities for hand hygiene compliance monitoring.