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Video Surveillance Audit of Hand-washing Practices in a Neonatal Intensive Care Unit. OBJECTIVE: To audit hand-washing practices by video-surveillance. METHODS: Six main steps (step 2 to step 7) of World Health Organizations hand hygiene technique with soap and water were used for evaluation. Handwashing was categorized as excellent, acceptable and unacceptable. RESULTS: Of 1081 recordings, 403 (37.3%) were excellent, 521 (48.2%) were acceptable and 157 (14.5%) were unacceptable handwash. Unacceptable handwashing was more prevalent in the night in comparison to daytime (17.5% vs 12.5%). Thirteen people washed their face after washing their hands. CONCLUSIONS: Innovative interventions are required to improve handwashing during night shifts.