Students' observations of hand hygiene in nursing homes using the five moments of hand hygiene.

Aims And Objectives: To use nursing students to observe hand hygiene adherence in nursing homes and to explore whether the students' reflections after observing hand hygiene practices gives them a deeper understanding of the subject matter.

Background: Residents in nursing homes worldwide have low tolerance for healthcare-associated infections that require antibiotics, and hand hygiene is the single most effective action to reduce infections.

Design: Observational study using (a) World Health Organization's (WHO) "Five moments for hand hygiene" validated tool to record indications and adherence and (b) an exploratory study of individual reflection notes from students conducted during and after observations.