Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India.

Vishal Diwan,Harshada Shah,Cecilia Stålsby Lundborg,Megha Sharma,Rita Joshi,Charlotte Gustafsson,Ashok J Tamhankar,Sudhir Chandra Joshi,Senia Rosales Klintz,Ashish Pathak

doi:10.1371/journal.pone.0163347

Vishal Diwan, Harshada Shah + Show 8 more

Open Access

https://doi.org/10.1371/journal.pone.0163347

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Abstract

AimTo describe self-reported practices and assess knowledge and attitudes regarding hand hygiene among healthcare workers in a rural Indian teaching hospital.SettingA rural teaching hospital and its associated medical and nursing colleges in the district of Ujjain, India.MethodThe study population consisted of physicians, nurses, teaching staff, clinical instructors and nursing students. Self-administered questionnaires based on the World Health Organization Guidelines on Hand Hygiene in Healthcare were used.ResultsOut of 489 healthcare workers, 259 participated in the study (response rate = 53%). The proportion of healthcare workers that reported to ‘always’ practice hand hygiene in the selected situations varied from 40–96% amongst categories. Reported barriers to maintaining good hand hygiene were mainly related to high workload, scarcity of resources, lack of scientific information and the perception that priority is not given to hand hygiene, either on an individual or institutional level. Previous training on the topic had a statistically significant association with self-reported practice (p = 0.001). Ninety three per cent of the respondents were willing to attend training on hand hygiene in the near future.ConclusionSelf-reported knowledge and adherence varied between situations, but hand hygiene practices have the potential to improve if the identified constraints could be reduced. Future training should focus on enhancing healthcare workers’ knowledge and understanding regarding the importance of persistent practice in all situations.

Highlights

Healthcare-associated infections (HCAIs) constitute a major threat to patients’ and healthcare workers’ (HCWs) safety globally[1]
Even though hand hygiene (HH) is reportedly performed to a great extent in certain situations, and while knowledge of when it should be performed is high, HH is not practiced in all situations dictated by WHO guidelines
Similar to results from other studies in India and other low- and middle-income countries (LMICs), HCWs in this setting report being overburdened by work and that essential resources required to perform HH are scarce

Summary

Introduction

Healthcare-associated infections (HCAIs) constitute a major threat to patients’ and healthcare workers’ (HCWs) safety globally[1]. Published evidence shows that hundreds of millions of patients are affected by HCAIs annually, with a greater burden in low- and middle-income countries (LMICs) [2]. Consequences of HCAIs include: prolonged hospital stay, higher rates of morbidity and mortality, a greater financial burden on health systems, high costs for patients and their families and increased antibiotic resistance (ABR) [1]. Pathogens are frequently transmitted from one patient to another via the hands of HCWs [4]. Use of ABHRs requires less time and reduces skin flora more rapidly than washing [7]. Proper implementation of HH significantly reduces the risk of cross-transmission of infections in healthcare facilities [6]

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Results

Discussion

Conclusion