Direct observation was used to assess hand hygiene compliance for both doctors and nurses in the emergency department using the same methods and observers as previously employed.
In addition to the 420 preintervention and 463 immediately postintervention observations previously reported, we observed another 456 clinician-patient interactions approximately 1 year after the intervention. Among all health care workers, there was no significant difference between hand hygiene compliance immediately postintervention (44.9 % ) compared with 1 year after the intervention (45.2 % ). Adherence among nurses, however, increased from 40.7 % to 49.8 % (P = .03), whereas adherence among doctors decreased from 50.5 % to 36.5 % (P = .008).
The overall effects of the intervention were sustained over a 1-year period, although a marked difference was observed between nurses and doctors.