AUTHOR=Angurana Suresh Kumar , Chetal Pooja , Mehta Richa , Suthar Renu , Sundaram Venkataseshan , Singh Ranjana , Kaur Rupinder , Kaur Harinder , Biswal Manisha , Kumar Praveen , Jayashree Muralidharan TITLE=Hand Hygiene Compliance in Pediatric Emergency of a Lower-Middle Income Country: A Quality Improvement Study JOURNAL=Frontiers in Pediatrics VOLUME=Volume 10 - 2022 YEAR=2022 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.869462 DOI=10.3389/fped.2022.869462 ISSN=2296-2360 ABSTRACT=Background: Prospective data on hand hygiene compliance in pediatric emergency department settings is limited. We studied the impact of quality improvement measures on the overall and health care personnel wise hand hygiene compliance rates in a busy PED. Methods: The baseline hand hygiene compliance rates were audited from May-July 2018. The quality improvement interventions included various structural changes to the environment, administrative changes and education and training. During the interventions, auditing was continued for two months (August – September 2018). Statistical Process control charts were created. Results: We observed a significant increase in overall compliance rates from 31.8% to 53.9% (p<0.001). These improvements were observed in the children (29.6% to 46.4%, p<0.001) as well as neonatal area (35.7% to 59.7, p<0.001) of PED as well as amongst various health care personnel and in four out of the five moments of hand hygiene. Conclusion: Hand hygiene compliance improved significantly in a busy PED of a lower middle-income country following quality improvement interventions. Such improvement was observed amongst all categories of health care personnel and different types of hand hygiene opportunities. This study demonstrates the feasibility and efficacy of simple quality improvement interventions in a challenging hospital environment.