Since the work of Ignaz Philipp Semmelweis, hand hygiene has been recognised as an effective means of preventing healthcare-associated infection. More recently, the World Health Organisation developed guidelines and strategies for improving hand hygiene compliance which have subsequently been adopted and implemented in healthcare facilities around the world. In Australia the imperative to ensure appropriate hand hygiene as a component of safe healthcare provision has been supported and promoted at state and national levels by various bodies. However, in spite of improvements in compliance rates and reported decreases in multi-resistant organisms, criticism has arisen around the commitment of scarce healthcare resources to hand hygiene auditing. This study demonstrates that hand hygiene audits can contribute to quality healthcare delivery and improvement.