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Table 5. Metrics for Reporting Adherence to Hand Hygiene
Measurement Numerator Denominator Stratification Metric
Direct overt
observations
a
No. of adherent
hand hygiene
opportunities
(HHO)
performed
No. of total
opportunities
• Unit
• HCP role
(Adherent
HHOs)/
(Total HHOs)
× 100
AHHMS Approximate
no. of hand
hygiene actions
detected by
sensors
Approximate
no. of hand
hygiene
opportunities
detected by
sensors
• Unit
• HCP role
• Individual
(Approximate
hand hygiene
actions)/
(approximate
HHOs) ×
100
a
Patient as
observer
No. of patient
reporting
adherence
Total number
of observations
submitted by
patients
Service area and/
or HCP role
(No. reporting
adherence
observations)/
(Total
observations)
× 100
Product
volume
Volume of
hand hygiene
product used
(e.g., alcohol-
based hand rub
or liquid soap)
for a specified
period in a
specified area
1,000 patient
days during
specified
period in
specified area,
or number of
patient visits for
outpatient areas
or emergency
departments
• Unit
• Service area
• No stratification
(i.e., facility-
wide)
Volume (mL)
per 1,000
patient days
or per patient
visit
Audits of
hand hygiene
supplies
No. of hand
hygiene stations
with defects
(e.g., lack
of adequate
supplies or not
functioning as
intended)
No. of hand
hygiene stations
assessed
• Unit
• Service area
(No. of hand
hygiene stations
without
defects)/
(No. of hand
hygiene stations
assessed) × 100
a
Direct overt observation should not be used to calculate adherence.
