• Henry Tsao, Rachel Macdonald, Damien Dwyer, Tracey Harper, Dominik Rutz, and John Sutherland.
• Emergency Department, Redland Hospital, Brisbane, Queensland, Australia.
• Emerg Med Australas. 2023 Apr 1; 35 (2): 213217213-217.

ObjectiveTo examine whether patient flow factors in the ED such as prolonged length of stay are associated with hand hygiene (HH) compliance.MethodsWe conducted a retrospective study at an urban district hospital utilising available data from January 2018 to December 2021. Compliance to the World Health Organization five moments of HH expressed as percentage of total moments observed were collated every 2 months. Patient flow measures including proportion of patients referred or discharged within 4 h (LOS4), proportion of patients with ED length of stay >24 h (LOS24) and total number of patient presentations, were obtained for each 2-month periods. The association between these patient flow measures and HH compliance was examined using Pearson's correlation (P < 0.05).ResultsThe results showed a moderate and significant association between rates of HH compliance and LOS24 (r = -0.48, P = 0.025). That is, lower proportion of patients with ED length of stay >24 h was associated with improved HH compliance. There was no significant correlation between HH compliance and LOS4 (r = 0.38, P = 0.085) or total number of ED presentations (r = -0.30, P = 0.17).ConclusionsThe findings show that prolonged ED length of stay may explain, at least partly, lower rates of HH compliance. Improvements in ED HH compliance should also include strategies that enhance patient flow.© 2022 Australasian College for Emergency Medicine.

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