Web site spotlight: Secret shoppers uncover staff hand hygiene compliance

Nurse Leader Insider, March 9, 2009

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If you want to see someone's true behavior, watch what they do when they think no one is looking, says Brian Hudson, MT (ASCP), CIC, an infection preventionist (IP) at Cleveland Regional Medical Center in Shelby, NC.

This is the idea behind secret shopper programs at various hospitals, which try to get a better picture of staff members' hand hygiene compliance by observing them when they don't think they're being watched.

"It's impossible for the infection control professional to do [an accurate hand hygiene observation] when they're rounding. People tend to run screaming to the closest sink when they see us," says Gayle Lovato, MS, RN, an IP at Inova Loudoun Hospital in Leesburg, VA.

The numbers support her observation. Research has shown that people are more likely to wash their hands after using the bathroom if someone else is in the bathroom with them than if they are alone, says Hudson.

Cleveland's secret shopper program found striking differences in compliance: Staff members are 90%-95% compliant with hand hygiene guidelines when they know they are being observed for hand washing compliance, but those numbers dip when they think no one is watching, Hudson says.

Editor's note: This excerpt was adapted from the article, "Secret shoppers help improve hand hygiene compliance" featured in The Reading Room on HCPro's online resource center,

Are you in need of continuing education (CE) credits? Check out this month's CE article on preventing surgical site infections or visit our archives and view a compilation of CE articles (marked with an asterisk).

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