Context:The role of hand hygiene in preventing health care associated infections (HCAIs) has been clearly established. However, compliance rates remain poor among health care personnel.Aims:a) To investigate the health care workers’ hand hygiene compliance rates in the intensive care unit (ICU), b) to assess reasons for non-compliance and c) to study the efficacy of a multimodal intervention strategy at improving compliance.Settings:A mixed medical–surgical ICU of a tertiary level hospital.Design:A before–after prospective, observational, intervention study.Materials and Methods:All health care personnel who came in contact with patients in the ICU were observed for their hand hygiene compliance before and after a multimodal intervention strategy (education, posters, verbal reminders and easy availability of products). A self-report questionnaire was also circulated to assess perceptions regarding compliance. Statistical analysis was done using χ2 test or Fisher exact test (Epi info software).Results:Hand hygiene compliance among medical personnel working in the ICU was 26% and the most common reason cited for non-compliance was lack of time (37%). The overall compliance improved significantly following the intervention to 57.36% (P<0.000). All health care worker groups showed significant improvements: staff nurses (21.48–61.59%, P<0.0000), nursing students (9.86–33.33%, P<0.0000), resident trainees (21.62–60.71%, P<0.0000), visiting consultants (22–57.14%, P=0.0001), physiotherapists (70–75.95%, P=0.413) and paramedical staff (10.71–55.45%, P< 0.0000).Conclusions:Hand hygiene compliance among health care workers in the ICU is poor; however, intervention strategies, such as the one used, can be useful in improving the compliance rates significantly.

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