Nelson Marlborough District Health Board hand hygiene compliance is up 20 per cent but still remains under the national average.
The board's compliance with the five key times hand washing is required has reached 70.1 per cent.
New Zealand uses one of the strictest and most rigorous approaches to measuring hand hygiene performance.
Rates of more than 70 per cent compare favourably with performance in other countries, the board said.
However, the score fell short of the 72.6 per cent national average from November 1 last year to March 31.
Board chief medical officer Dr Nick Baker said the level of compliance had increased by 20 per cent since June 2012.
"Healthcare workers throughout Nelson Marlborough District Board are working extremely hard to improve the hand hygiene performance and should be congratulated for their efforts," Baker said.
The World Health Organisation's five moments for hand hygiene approach requires hand hygiene to be performed at the following times, irrespective of whether or not gloves are used: before patient contact, before a procedure, after a procedure or body fluid exposure risk, after patient contact and after contact with patient surroundings.
Baker said the changes showed hand-washing practices in the key areas were becoming embedded.
"Hand washing is a basic step that costs nothing and acts as a barrier to disease for both the patient and the clinician.
"While the data was encouraging it still meant that 30 per cent of the time not all five moments of hand hygiene are being followed. This is not about staff not washing their hands at all but about staff washing in five different situations before and after potential risk.
"Patients rely on their clinicians to provide the highest standard of care and anyone who is not participating in the five moments of hand hygiene is letting themselves down, letting their team down and ultimately letting their patients down."
Baker said the board was reviewing ways it trained, monitored and supported staff to continue improving its score.
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