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Manual auditing has long been considered as the gold standard for measuring concordance with hand hygiene protocol. Until recently, it could be argued that it was the only valid methodology available. This is despite the fact that self-auditing has long been deemed to be unreliable, and even “Secret Shopper” audits have been found to produce biased results due to variances in the methodology used and to the ‘Hawthorne Effect’[1].  In the UK NHS, compliance rates >90% are widely reported [2], leading Trust management to believe that hand hygiene is under control and no additional time or money will be spent improving practice.  Electronic monitoring systems are available, which due to their different methodology, provide alternative yet complementary results.

Comparing traditional audits with electronic measurements: bringing a new perspective to measurement of compliance with hand hygiene protocols