Abstract
This study investigated healthcare workers’ perceptions of hand hygiene practices by comparing personal reports, as assessed by questionnaires, to direct observations of the workers’ hand hygiene practices. The study employed a cross-sectional research design. Observations were made using a 16-item checklist, based on three sources: Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and Boyce and Pittet’s guidelines of hand hygiene. The checklist was used for both direct-observation and self-reported data collection purposes. Pearson correlation and Multivariate Analysis of Covariance (MANCOVA) were utilized to statistically determine the relationship between healthcare workers’ reports of hand hygiene practices and observed hand hygiene behaviors. The study was conducted in the outpatient examination rooms and emergency departments of three types of hospitals in the Eastern region of Saudi Arabia where Middle East respiratory syndrome coronavirus (MERS-CoV) is endemic and is observed in routine cases and outbreaks. The total sample size included 87 physicians and nurses recruited while on duty during the scheduled observation periods, with each healthcare worker being observed during individual medical examinations with at least three patients. No statistically significant correlations between the healthcare workers’ perceptions of hand hygiene practices and healthcare workers’ actual behaviors were evident. Based on the self-report questionnaires, significant differences were found between physicians’ and nurses’ hand hygiene practices reports. Healthcare workers clearly understand the importance of careful hand hygiene practices, but based on researchers’ observations, the medical personnel failed to properly implement protocol-driven hand hygiene applications. However, the significant differences between physicians’ and nurses’ self-reports suggest further inquiry is needed to fully explore these discrepancies.
Highlights
Middle East respiratory syndrome (MERS) is a type of coronavirus first discovered in Saudi
Conduct of this study increased the awareness of hand hygiene issues in healthcare settings in Saudi Arabia
This study evaluated compliance with hospital hand hygiene policy in multiple types of Saudi Arabian hospitals in Eastern Saudi Arabia and considered the role played by healthcare settings and practice differences, since doctors tend to stay in a single office and patients rotate through each doctor’s office
Summary
Middle East respiratory syndrome (MERS) is a type of coronavirus first discovered in Saudi. Arabia in 2012 [1,2]. The virus causes a range of respiratory and gastrointestinal symptoms including fever, cough, shortness of breath, and diarrhea. Infections may progress to pneumonia and organ failure leading to approximately 35% reported mortality rate [3]. MERS in the region was previously attributed to local bats. Recent studies indicated that animal to human transmission is a cause, but with camels, instead of bats, as the most likely source [4]. Per an August 2017 Ministry of Health Report 4, the MERS coronavirus has infected a total of 1609 people
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