- •The accuracy of direct hand hygiene observation is challenged by Hawthorne effect.
- •Hawthorne effect was quantified at a tertiary care setting in the current study.
- •Overall hand hygiene compliance was 87.1% using overt observation.
- •Overall hand hygiene compliance was 44.9% using covert observation.
- •The overestimation was seen in all professions, hospital settings, and indications.
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Conflicts of interest: None to report.