Hand hygiene tough to enforce, measure

My lede:

Proper hand hygiene is one of the most important infection-control techniques. Yet getting doctors and others who encounter patients to clean their hands at the right times and in the right manner has proven to be daunting, with studies showing compliance rates of about 50% nationally.

Nearly as perplexing as why many who know better sometimes skip hand washing is how to accurately measure hand-hygiene rates.

The whole shebang.