Abstract:Objective To investigate the current status of hand hygiene (HH)compliance with concealed observation method, compare compliance rates of HH of health care workers (HCWs) obtained through concealed observation method, direct observation method and monitoring observation method, provide effective surveillance methods and means for further improving HH compliance. Methods Data about HH compliance and HH products consumption in a hospital obtained through monitoring observation method, concealed observation method, and direct observation method were collected, all observed HCWs have received unified training, the correlation among three me-thods and HH consumption were explored. Results Differences in HH compliance rates obtained by different observation methods were statistically significant (χ2=17.401, P＜0.001). The direct observation method had the highest HH compliance rate at 95.08%, while the concealed observation method had the lowest HH compliance rate at 50.83%. The daily consumption of HH products was highest in department of neonatology, at 119.14 mL/bed-day, and lowest in department of pediatrics, at 10.39 mL/bed-day. The monitoring observation method (r=0.975, P=0.005) and the concealed observation method (r=0.949, P=0.012) had a good correlation with the consumption of HH products. The concealed observation method showed that the department with the highest HH compliance rate was department of neonatology, at 90.00%. Conclusion The actual HH compliance can be indirectly reflected by comprehensive monitoring observation method and the consumption of HH products per bed-day.