ArticleGMS hygiene and infection control2025
Comparison of overtly and covertly observed hand antisepsis adherence in the intensive care units of a referral hospital in Iran.
Article in GMS hygiene and infection control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and objective: Hand antisepsis one of the most important strategies for preventing transmission of drug-resistant microorganisms and healthcare-associated infections. Overt observation of hand antisepsis in healthcare settings is currently considered the gold standard for monitoring its adherence rate. However, a major limitation of this method is the "Hawthorne effect", wherein health staff who know they are being assessed may alter their behavior. In this survey, we aimed to compare the overt and covert methods of observation of hand hygiene. Method: This cross-sectional descriptive-analytic study was conducted over six months in the intensive care units (ICUs) of Namazi Teaching Hospital in Shiraz. The study population comprised ICU staff, including nurses, physicians (specialists and residents), and other healthcare workers (HCWs) in direct contact with patients. Convenience sampling was used. Hand antisepsis adherence was assessed through both overt (open) and covert (hidden) observations across different work shifts. Data was collected using the "WHO Hand Hygiene Observation Checklist" and analyzed in SPSS 18 using descriptive statistics and the chi-squared test. Results: The findings revealed that in a total of 9 ICUs (including 4 surgical, 2 medical, and 3 general ICUs) with over 90 active beds, 776 opportunities were observed through overt observation and 1,780 opportunities through covert observation. Overall, hand antisepsis adherence was 58.4% in overt observation and 60.3% in covert observation (p=0.352, RR=0.96). A significant difference was found in adherence rates among certain professional groups and specific hand antisepsis opportunities. Discussion and conclusion: No significant difference was found in hand antisepsis adherence between overt and covert observation methods, suggesting that both approaches are suitable to assess the in health care centers. It is essential to institutionalize hand antisepsis as an occupational culture in healthcare settings. Raising awareness among healthcare teams about the severe consequences of hospital-acquired infections can provide the necessary motivation for consistent and proper hand antisepsis practices.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.