The audits, part of an ongoing public hospitals hand-hygiene campaign that began in 2008 and now extends throughout the country, looked at 200 hand-hygiene "moments" (see fact box) before any special education had been carried out or improvements made.
Dunedin Hospital's infection prevention and control charge nurse manager, Jo Stodart, said the " baseline audit" showed 36.38% overall compliance - which improved to 58.28% five months later.
A third audit is under way, but improvements are not expected to be so dramatic.
Mrs Stodart would not name particular areas or types of staff where compliance was poor, saying the point of the project was not to issue blame, but to see where the difficulties lay and work out how to improve them.
A year ago, the hospital's review of the 2008 norovirus outbreak identified refusal of some staff to comply with infection control measures as a major problem.
Mrs Stodart is one of the project's five top "platinum auditors" in the country, helping to ensure that auditing and education is consistent.
The initial audit showed that the two instances when compliance was poorest were before patient contact and after touching a patient's surroundings.
Mrs Stodart said the before-patient compliance had been helped by placing hand gels on the ends of beds instead of outside rooms.
There were other challenges to gel use, such as ensuring that they were replaced.
Touching curtains as staff left a patient's bedside contaminated hands, so staff were being trained to use elbows to move curtains.
The use of gloves, while necessary in some circumstances, caused problems when staff thought just the fact of wearing them meant they were being hygienic, or did not dispose of them properly.
Some also made the mistake of gelling them, which made them perish.
Hand hygiene is part of orientation training for all staff at the hospital.
Mrs Stodart felt progress was being made on awareness of the issues, with the use of hand gels making "a huge difference" in an ageing hospital that did not have a lot of sinks.
She considered improved practices across the hospital and in the community had helped to ensure that this year, there had been only one very small outbreak of infectious disease in the hospital.
It was, however, a long-term project, with the aim of 100% compliance in all areas.
Next week is Infection Prevention Week, with emphasis on individual responsibility.
People will be asked to look at their own practice and the impact that might have.
A 2003 report estimated that that up to 10% of patients admitted to hospitals in the developed world acquired one or more infections.
In New Zealand at that time, the annual cost of such infections was estimated to be almost $140 million.
