Background and Objective:
A higher compliance of healthcare personnel with hand-hygiene corresponds to a lower incidence of nosocomial infections. Since 2013, the Hospital Hygiene Service of the University Hospital of Modena (Modena Polyclinic and Baggiovara Hospital) has developed the ""Hand-Hygiene Project"": observation at time 0, room training, on-field feedback, data return. The aim of the study was to carry out a standardized observation of the healthcare personnel’s compliance with WHO Five Moments of Hand-Hygiene in the University Hospital of Modena in 2022.

Methods:
Adherence to hand-hygiene (4 categories per WHO-moment: ""1-rub"" and ""2-wash"": correctly rubbing hands with hydroalcoholic gel or washing with soap and water; ""3-incorrect use of gloves"" or ""4-none"", the operator does not sanitize his hands) was assessed collecting the data in the WHO survey forms and recording it on the regional MAppER platform. Observations were conducted on 219 physicians (89 trainees), 303 nurses/midwives and 110 nursing assistants in 13 wards between 24-3-2022 and 30-11-2022.

Results:
Out of a total of 4097 WHO moments observed, hand-hygiene compliance was found to be 69.7%. Adherence to moments 1, 2, 3, 4, 5 was respectively 61%, 60%, 74%, 80% and 70%. Overall adherence was 66.2% for doctors (out of 1194 observations), 71.6% for nurses/obstetricians (2229), 69.7% for nursing assistants (669). Adherence was 94.9% in the Intensive Care Unit (ICU), 84.7% in pediatric wards and 74.8% in medical wards. With the project, participation has increased from 54% to 80% in the Baggiovara Hospital and from 36% to 73% at the Modena Polyclinic.

Conclusions:
Adherence to hand-hygiene was good, rather uniform among healthcare professionals (doctors were slightly lower-rated) and clearly growing with the adoption of the ""Hand Hygiene Project"". The extraordinary adherence observed in the ICU is also related to a previous project involving a focused training of four operators per ward.