New figures have revealed doctors and other hospital staff regularly fail to clean their hands properly despite a major drive to cut hospital-acquired infections.
Almost one in ten routine inspections of wards across NHS Grampian found too few were following “simple” rules.
A dialysis unit and a winter pressures ward were among those with the poorest ratings at Aberdeen Royal Infirmary.
And Raigmore Hospital in Inverness, run by Highland NHS, failed to hit the national minimum standard every month from April to September.
NHS Grampian conceded that some of its results, a decade on from the launch of a national campaign, were “disappointing”.
It carried out 2,336 inspections over the last year – each monitoring 20 consecutive “opportunities” when hands should be cleaned.
The Scottish Government demands that in at least 19 of those the individual cleans when they should and does so thoroughly.
But detailed results for the last 12 months, obtained by the Press and Journal under freedom of information laws, show repeated failures.
In Grampian, 243 inspections were sub-95%, more than one in ten.
Of those, 117 were at Aberdeen Royal Infirmary and its emergency care centre, with 17 at Dr Gray’s in Elgin and Aberdeen Maternity Hospital, 14 at Woodend, 13 at the Royal Aberdeen Children’s Hospital and 11 at Fraserburgh.
On one occasion, in an orthopaedic ward at Dr Gray’s, only a quarter were seen to wash their hands properly, if at all.
And five other times the number was less than half – Kinnaird ward, Fraserburgh (40%), Summers ward, Peterhead (45%), Turriff ward, Turriff (45%), ARI winter pressures ward (48%) and ARI dialysis unit (49%).
A board spokeswoman said it took hand hygiene “extremely seriously”.
“Some of these results are disappointing,” she added.
Individual staff who failed were informed and firm action was always required from under-performing wards, she said.
Raigmore Hospital as a whole scored between 90% and 93% for each of the six months from April.
An NHS Highland spokesman said: “The board have been informed of this and are aware of the ongoing work to improve auditing and validating practice and policies in relation to hand hygiene standards.”
A spokesman for Healthcare Improvement Scotland said patients and the public “deserve to have complete confidence in the safety and cleanliness of our hospitals”.