LAUSR

Key Points Question How have audit-and-feedback programs based on direct observations of hand hygiene compliance been implemented in real-world settings? Findings In this qualitative study of 108 hospital staff members in 10 acute care hospitals, the use of audit and feedback to improve hand hygiene compliance was problematic. Auditing by direct observation was perceived to collect inaccurate data and created tension with frontline staff, and the feedback process did not appear to encourage positive change. Meaning Strategies are needed to collect more reliable hand hygiene data and facilitate multidisciplinary collaboration toward improved hand hygiene compliance.