Hand hygiene practices among nursing staff in public secondary care hospitals in Kuwait: self-report and direct observation.

Objective: To assess the compliance with hand hygiene guidelines among nursing staff in secondary care hospitals in Kuwait.

Subjects And Methods: A cross-sectional study was conducted through direct observation using the Lewisham observation tool and self-administered questionnaire in six major public secondary care hospitals in Kuwait. Only patient care activities that are described as 'dirty contacts' by the Fulkerson scale were considered as indications for hand hygiene while any attempt for hand hygiene was considered as compliance.