Adherence to good hand hygiene (HH) practices is the cornerstone for preventing healthcare-associated infections (HAI). Through sustained efforts and performance of annual HH program since 2004 National Taiwan University Hospital (NTUH) was accredited of “2011 Asia Pacific Hand Hygiene Excellence Award” among 108 hospitals in this region. This experience may apply to other measures for patient safety and combating antimicrobial resistance.

Hospital-wide HH program, with particular emphasis on using an alcohol-based hand rub, was implemented in April 2004 at NTUH. We observed 8,420 opportunities for HH during April 2004 to Dec 2007. Compliance (before and after patient contact) improved from 43.3% in April 2004 to 95.6% in 2007, and was closely correlated with increased consumption of the alcohol-based hand rub. The disease severity score (Charlson comorbidity index) increased during the intervention period. Nevertheless, we observed an 8.9% decrease in HAIs and a decline in the occurrence of bloodstream, methicillin-resistant Staphylococcus aureus, extensively drug-resistant Acinetobacter baumannii, and intensive care unit infections. The net benefit of the HHP was US$5,289,364, and the benefit-cost ratio was 23.7 with a 3% discount rate.