One moment doctor! Have you forgotten hand hygiene?

Hospital infection prevention indices are improving, but reducing infection rates further requires professional culture change T he " Five Moments For Hand Hygiene " 1 promoted by the World Health Organization are logical and uncomplicated, but some health care workers nevertheless fi nd them confusing. Nurses are more likely to understand the fi ve moments because of repeated exposure to them — during in-service training and regular review of ward audit results — but doctors often avoid these opportunities , because of more pressing and important commitments. Unfortunately, attempts to simplify can increase the confusion; for example, the hand hygiene policy of the New South Wales health department, which merges moments 4 (after any non-procedural contact with a patient) and 5 (after contact with a patient's surroundings), 2 confl icts with the requirement to audit all fi ve moments separately. Doctors have consistently been reported to be less compliant with hand hygiene practices than nurses. 3,4 3,4 The latest Australian hand hygiene audit data, for the third period in 2013, 5 show that average compliance rates of doctors and nurses were 66% and 83%, respectively. Despite improvement since the National Hand Hygiene Initiative began in 2009 (from 46% and 68%, respectively), the gap remains. The analysis of recent hand hygiene data by Azim and