Hand Hygiene Knowledge Research Articles

The impact of a hand hygiene workshop on improving the knowledge of hand hygiene of medical students

Introduction and Objectives: Knowledge of hand hygiene is important for medical students. The aim of this study was to compare the knowledge before and after a workshop on hand hygiene held for medical students at the Faculty of Medicine, General Sir John Kotelawala Defence University, Sri Lanka. Methods: A self-administered, pre-tested validated questionnaire, based on hand hygiene guidelines of the World Health Organization (WHO), was distributed among the medical students before and after conducting a workshop on hand hygiene.Results were assessed by comparing the current guidelines set by the WHO with the knowledge of hand hygiene among the medical students. Results: All 177 students participated in the study before conducting the workshop. There were 104 (58.8%) preclinical and 73 (41.2%) clinical students. Of the 104 preclinical students, the percentage who knew the importance of “My five moments for hand hygiene” approach (hand hygiene before direct contact with patients, after direct contact with patients, before clean/aseptic procedures, after contact with blood/body fluid and after contact with patient’s surrounding) before conducting the workshop were 53.8%, 67.3%, 51.0%, 88.5% and 34.6% respectively. Of the 73 clinical students, the percentage who knew the importance of the “My five moments for hand hygiene” approach before conducting the workshop were 49.3%, 63.0%, 87.7%, 94.5% and 27.4% respectively. Of the 112 students who participated in the workshop, there were 68 (60.7%) preclinical and 44 (39.3%) clinical students. Of the 68 preclinical students, 77.9%, 79.4%, 91.2%, 95.6% and 70.6% knew the importance of the “My five moments for hand hygiene” approach post workshop. Post workshop, the percentage of the 44 clinical students who knew the importance of “My five moments for hand hygiene” approach were 90.9%, 88.6%, 93.2%, 97.7% and 81.8% respectively. Conclusions: The pre workshop knowledge of hand hygiene among the two categories of medical students was not satisfactory. The knowledge on each component of “My five moments for hand hygiene” concept improved to more than 70% after conducting the workshop.

Hand hygiene compliance and environmental contamination with gram-negative bacilli in a rural hospital in Madarounfa, Niger.

BackgroundHealthcare-associated infections pose a major, yet often preventable risk to patient safety. Poor hand hygiene among healthcare personnel and unsanitary hospital environments may contribute to this risk in low-income settings. We aimed to describe hand hygiene behaviour and environmental contamination by season in a rural, sub-Saharan African hospital setting.MethodsWe conducted a concurrent triangulation mixed-methods study combining three types of data at a hospital in Madarounfa, Niger. Hand hygiene observations among healthcare personnel during two seasons contributed quantitative data describing hand hygiene frequency and its variability in relation to seasonal changes in caseload. Semistructured interviews with healthcare personnel contributed qualitative data on knowledge, attitudes and barriers to hand hygiene. Biweekly environmental samples evaluated microbial contamination from October 2016 to December 2017. Triangulation identified convergences, complements and contradictions across results.ResultsHand hygiene compliance, or the proportion of actions (handrubbing or handwashing) performed out of all actions required, was low (11% during non-peak and 36% during peak caseload seasons). Interviews with healthcare personnel suggesting good general knowledge of hand hygiene contradicted the low hand hygiene compliance. However, compliance by healthcare activity was convergent with poor knowledge of precise hand hygiene steps and the motivation to prevent personal acquisition of infection identified during interviews. Contamination of environmental samples with gram-negative bacilli was high (45%), with the highest rates of contamination observed during the peak caseload season.ConclusionLow hand hygiene compliance coupled with high contamination rates of hospital environments may increase the risk of hospital-acquired infections in sub-Saharan African settings.

Effectiveness of Hand Hygiene Promotional Program based on the WHO Multimodal Hand Hygiene Improvement Strategy, in Terms of Compliance and Decontamination Efficacy in an Indian Tertiary Level Neonatal Surgical Intensive Care Unit

AbstractBackground: The WHO Multimodal Hand Hygiene Improvement Strategy (MHHIS) has been proposed to improve the Hand Hygiene (HH) compliance of the WHO recommendations on HH.Therefore, the current study was planned in our neonatal unit with the objective of evaluating the effectiveness of a Hand Hygiene Promotional Program (HHPP) based on the WHO MHHIS, in terms of compliance and decontamination efficacy among the health-care workers (HCWs) in the unit. Objective: The objective of the study was to evaluate the effectiveness of the WHO MHHIS on HH compliance and decontamination efficacy. Methods: The HHPP was carried out in our neonatal surgical intensive care unit from July to August 2013. A pre-intervention phase consisted of assessment of ward infrastructure, HH knowledge and perception, determination of HH compliance and collection of hand rinse samples from the HCWs before and after handwashing. Intervention phase consisted of changing traditional to elbow-operated taps, display of posters and reminders, placement of soaps in water draining trays, autoclaved single-use paper towels for hand drying, availability of hand rubs and training sessions for health-care providers. In the post-intervention phase, all the assessments and observations of pre-intervention phase were repeated. Results: HHPP resulted in a significant increase in overall HH compliance from 26.6% (95% confidence interval [CI] 23.9–29.3) to 65.3% (95% CI 62.4–68.2) (P < 0.001) and reduction in load of microorganisms (P = 0.013). There was a significant improvement in HH knowledge (P < 0.001), and perception surveys revealed high appreciation of each strategy component by the participants. Conclusion: To the best of our knowledge, this is the first study about the effect of implementation of the WHO MHHIS from an Indian hospital. HHPP was found to be effective in terms of HH compliance and decontamination efficacy. Its implementation is highly recommended to promote HH in a developing country like India.

Veterinarians’ Perception, Knowledge and Practices of Hand Hygiene in Enugu State Southeast, Nigeria

A cross-sectional survey utilizing questionnaire assessed veterinarians’ awareness, attitudes and practices of hand hygiene (HH) in Enugu State Southeastern Nigeria. Data obtained were analyzed using chi-square on SPSS (version 15.0) at a significance level of P &lt; 0.05 to determine possible associations between variables and perceptions/knowledge about HH. Out of 294 respondents, 26.9% were familiar with the WHO’s “5 moments of HH” model but majority knew the importance of the model. There was high compliance with HH after touching an animal (100%) and animal’s surrounding (96%), and contact with body fluid (100%) but HH before touching an animal (52.5%) and performing clean procedures (58.5%) were practiced sub-optimally. Majority of the respondents often forgets to perform HH (61.9%) and prioritizes clinical tasks to HH when busy (65%). The attitudes/practices towards HH were generally negative. Minority knew that unclean veterinary personnel’s hands are the main route of infection in the veterinary clinic (38.1%) and alcohol-based hand rubs are more effective on pathogens than other cleansing agents (23.1%). Majority of the respondents does not know when different HH techniques ought to be performed. The overall knowledge of HH by the respondents was moderate (55.4%). No significant association (P &gt; 0.05) was found between level of knowledge and gender, age, qualification, duration of practice and location. Poor knowledge of HH guidelines, unavailability and inaccessibility of HH facilities, and unavailability of reminders were the major barriers to compliance with appropriate HH practices. In conclusion, veterinarians’ awareness and perception about HH in the study area is moderate while the practices are sub-optimal, thus the education of Nigerian veterinarians about HH and the teaching of the principles and practices of appropriate HH during veterinary schools are recommended.

Impact of hand hygiene knowledge on the hand hygiene compliance.

Aim Hand hygiene practice is still burdened by inadequate compliance, whether in the professional sphere by health professionals or in the non-professional sphere by lay population. Aim of this study was to map the hand hygiene knowledge and its compliance in the monitored group of people. Methods The research was conducted at the Jessenius Faculty of Medicine in Martin of Comenius University in Bratislava (JFM CU) among seventy 3rd year students of General Medicine (medical study program), and Nursing, Midwifery and Public Health (non-medical study programs). Knowledge of hygienic hand washing according to the WHO guidelines from 2009 was investigated, as well as differences in the level of microbial contamination of hands after routine hand washing between the group that had been acquainted with hand hygiene protocols and the group that had not sufficiently. Results The results have shown that 32.9% of the students did not perform hygienic hand washing properly. The differences between the groups of students with and without the proper hand hygiene compliance in routine hand washing were not statistically significant. Conclusion The results of our survey have suggested that the reasons for decreased compliance with hand washing protocols may be related to forgetting to wash the hands or not being acquainted with hand washing protocols at all. The strategies focused only on one aspect of hand hygiene are, according to scientific literature, ineffective in the long term.

Hand hygiene of nursing and midwifery students in Cambodia.

To determine the relationship between knowledge, attitude and the practice of hand hygiene by nursing and midwifery students in Cambodia. Hand hygiene is the most cost-effective means to prevent hospital-acquired infections. Techniques of hand hygiene are simple; however, many researchers have found hand hygiene knowledge, attitude and practice to be poor in many healthcare settings worldwide, especially in developing countries. Cambodia is a developing country in Southeast Asia and data regarding hand hygiene are limited. A cross-sectional descriptive study was conducted to assess the level of knowledge, attitude and practice of hand hygiene. Students in nursing and midwifery programmes were the target population (n=300). Survey data were collected from January to May 2017. Descriptive statistics, t-tests and correlation coefficients were calculated to assess relationships between student knowledge, attitude and hand hygiene practice. The level of knowledge, attitude and practice of hand hygiene in nursing and midwifery students was moderate. A majority of students had received hand hygiene training. There was no significant difference between nursing and midwifery students in knowledge, attitude and practice of hand hygiene. However, a Pearson correlation of attitude and practice had a weak positive relationship. Both nursing and midwifery students demonstrated moderate levels of knowledge, attitudes and practice of hand hygiene. This study identified a need for hand hygiene training. Developing training programmes to improve attitudes about hand hygiene is strongly recommended. Effective training may contribute to change behaviours of hand hygiene (attitude), improve practice and ultimately reduce hospital-acquired infections.

Hand hygiene knowledge, perception and practice of healthcare workers in a Turkish university hospital intensive care unit.

While improvement of hand hygiene (HH) compliance is considered as the best approach to reduce healthcare-associated infections, the instructional interventions in HH among healthcare workers of intensive care unit (ICU) of our hospital was not successful enough. The following study was conducted to evaluate HH knowledge, perception, practice and effectiveness of the trainings among healthcare workers of ICU in our hospital. A cross-sectional study was conducted in the ICU containing 8 medical and 16 surgical beds with 284 filled questionnaires about HH knowledge and 1187 observed opportunities for HH compliance. Overall observed HH compliance rate was 40.6%; lowest compliance was 21.7% for "before clean/aseptic procedure" indication and highest compliance was 68.6% for "after touching a patient" indication. Although > 90% healthcare workers correctly identified the World Health Organization's five indications for HH, 82 - 85% failed to recognize non-indications, i.e. when it was not necessary to perform HH. Our study showed that 15.1% of healthcare workers neither received nor felt the need for HH training. Despite regular HH trainings, healthcare workers could not differentiate when HH was not required which suggested failure to understand HH rationale. This may explain poor HH compliance rates. A systematic study is needed in order to find out the reasons behind of this noncompliance and improve HH training methods for educating healthcare workers.

Knowledge and attitude study among the nursing staff working in a tertiary care hospital in Southern India

Background: Hand hygiene is recognised as one of the leading measure to prevent cross transmission of micro-organisms. Inadequate hand hygiene practices are common cause of nosocomial infections. Nurses are considered as the “nucleus of health care system” Because of the time they spend with patients than any other health care workers. Hence their compliance with hand washing guidelines seems to be more vital in preventing the disease transmission among patients.Methods: Despite the simplicity of the procedure, compliance with hand hygiene among health care providers in particular nurses is as low as 40%. This study aims at assessing knowledge, attitude and practice of hand hygiene of the nursing staff working in a tertiary care hospital.Results: Among the 140 study participants 74% were female nurses. Majority of the study participants (78%) had average knowledge of hand hygiene in the pre-test session The health education and training session on correct hand hygiene methods significantly(p&lt;0.001) improved the knowledge and attitude of the nursing staff, during the post-test session 87% of the nurses had good knowledge and 100% had positive attitude.Conclusions: Our study shows the importance of improving the current training programmes targeting the hand hygiene practices among nursing staff. Hand hygiene training sessions need to be conducted more frequently with continuous monitoring and performance feedback to encourage them and their fellow nurses to follow correct hand hygiene practices.

Healthcare-associated infections and compliance of hand hygiene among healthcare workers in a tertiary health facility, southwest Nigeria.

Healthcare-associated infections (HAIs) are threats in healthcare settings contributing to increased morbidity, mortality and antimicrobial resistance worldwide. Hand hygiene (HH) is the simplest and most important single intervention to reduce HAIs. This study sought to determine rates of HAIs as well as compliance of HH among healthcare workers (HCWs) in Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC). A cross-sectional study was conducted among 227 HCWs (59 doctors, 129 nurses and 39 ward attendants) selected by multistage sampling across 10 hospital wards. Electronic interviewer-administered questionnaire, HH compliance checklist and point prevalence of HAI were done using World Health Organization and Centers for Disease Control and Prevention toolkits, respectively. Only 20.33% (n = 12) of doctors, 3.88% (n = 5) of nurses and 2.56% (n = 1) of ward attendants had good knowledge of HH (χ2 = 22.22, P value = 0.01). Among doctors, 11.86% (n = 7), 6.98% (n = 9) of nurses and 2.56% (n = 1) of ward attendants had positive perception towards HH (χ2 = 7.87, P value = 0.25). Of the 174 opportunities for HH observed, compliance rates were 42.37%, 55.81% and 68.97% among doctors, nurses and ward attendants, respectively. Point prevalence of HAI was 16.38%. Good knowledge and positive perception about HH were uncommon among doctors, nurses and ward attendants. However, ward attendants had the highest compliance to HH. There was a high prevalence of HAIs in this institution.

Assessment of Knowledge, Attitude and Practice of Hand Hygiene in Healthcare Workers of Gulab Devi Chest Hospital Lahore, Pakistan

Background: Hand hygiene is a general term referring to any action of hand cleansing by using water and detergent and for the removal of transient microorganisms from hands. Hand hygiene is recognized as the leading measure to prevent cross-transmission of microorganisms and to reduce the incidence of healthcare associated infections. There are many experiences that the lack of knowledge, attitude and poor practice in hand hygiene in healthcare workers transmit infection in patients and in other healthcare workers.&#x0D; Methodology: This descriptive study was conducted in Gulab Devi Chest Hospital. I had taken 100 healthcare workers to complete my research. The sampling technique of my research was cross-sectional sampling technique, use to collect the data.&#x0D; Results: In this research knowledge was not good in all HCWs, Overall knowledge of hand hygiene by all HCWs was less than 50%. The attitude in nurses and medical student in this research was moderate doctors and technologists have poor attitude in hand hygiene. The practices among HCWs in Gulab Devi Chest Hospital were also poor which was less than 50%.&#x0D; Conclusion: The HCWs in Gulab Devi Hospital had poor knowledge, practices on hand hygiene. However, attitudes of medical student and nursing had satisfactory.

Assessment of Knowledge, Attitude and Practice of Hand Hygiene in Healthcare Workers of Gulab Devi Chest Hospital Lahore, Pakistan

Assessment of Knowledge, Attitude and Practice of Hand Hygiene in Healthcare Workers of Gulab Devi Chest Hospital Lahore, Pakistan

요양병원 인증제 시행이 환자안전 관리활동에 미치는 영향: 손위생을 중심으로

The purpose of the study is to examine healthcare workers’ hand hygiene perception, knowledge, and self-reported compliance in accreditated long-term care hospitals in Korea. Perceptions on hand hygiene before and after the national accreditation are compared. We further investigated factors associated with perception, knowledge, and compliance. The introduction of national mandatory accreditation on long-term care hospitals since 2013 resulted in improved hand hygiene compliance and perception among hospital workers. Self-reported hand hygiene compliance rate was 89.7%. Perception is strongly in favor of hand hygiene compliance. Additionally, education level, profession department, and hand hygiene education exposure increased the likelihood of self-reported hand hygiene compliance. Results have implications for efforts to increase hand hygiene compliance rate and improve patient safety culture in long-term care hospitals.

Effects of behavioral ecology model in healthcare-associated infection management

Objective To explore the effects of behavioral ecology model in healthcare-associated infection management. Methods By random sampling, we selected 800 medical records at Nanyang City Center Hospital of He'nan Province from June 2015 to May 2016 in control group, and 800 medical records from June 2016 to May 2017 in observation group. Control group adopted routine healthcare-associated infection management. On the basis of that in control group, observation group carried out the management with the behavioral ecology model. We compared the nosocomial infection rate, bacterial distribution, knowledge of healthcare-associated infection as well as the qualified rate of hand hygiene between two groups. Results There were 14 cases (1.75%) with healthcare-associated infection in observation group less than that in control group with a statistical difference (χ2=7.913, P=0.006) . Observation group distributed 395 nosocomial infection related pathogens, while control group distributed 475 of that. The scores of knowledge of healthcare-associated infection and hand hygiene in observation group were (96±15) and (98±12) respectively higher than those in control group with statistical differences (P<0.05) . Conclusions The application of behavioral ecology model in strengthening the interaction among consciousness, environment and behavior can improve the cognition on healthcare-associated infection, knowledge and rate of hand hygiene of nurses, reduce the rate of hand hygiene which had positive effects on healthcare-associated infection control. Key words: Nursing staff; Cross infection; Management; Behavioral ecology

Knowledge and practice of hand hygiene among hospitalised patients in a tertiary general hospital in China and their attitudes: a cross-sectional survey

ObjectivesWe aimed to gain a better understanding of patients’ practice of hand hygiene (HH) and their knowledge and attitudes.DesignA cross-sectional survey.SettingA 3500-bed university-affiliated medical hospital in China.ParticipantsInpatients and their family...

Nursing Students' Knowledge of Hand Hygiene and Hand Hygiene Compliance Rate during On-site Clinical Training

Nursing Students' Knowledge of Hand Hygiene and Hand Hygiene Compliance Rate during On-site Clinical Training

PIN12 ASSESSING KNOWLEDGE ABOUT HAND HYGIENE IN A CITY HOSPITAL, HUNGARY

The aim of our study was to assess the knowledge about hand hygiene among workers of a city hospital using a questionnaire. A quantitative, cross-sectional study was carried out among hospital workforce with non-probability sampling method (n=155) between April-August 2018. WHO’s “Hand Hygiene Knowledge Questionnaire for Health-Care Workers” was validated and used for data collecting, extended with socio-demographic factors as well. Applied statistical methods: descriptive statistics, χ2-test (p<0.05). MS Excel and SPSS were used for calculating results. Mean age is 45.33 years (SD: 10.59), years worked in health is 21.45 on average (SD: 11.96). According to occupation, 27.7% of the sample are physicians, 39.4% are nurses and 32.9% are other workers. Knowledge about pathogens’ spreading path is significantly different between physicians (72.1%) and other workers (33.3%) (p<0.001). There is also significant difference in knowledge about the hand sanitizer’s exposure time between those who work in an operating room (91.3%) and those who work in departments (64.8%) (p=0.037). From the two types of disinfection (washing, alcoholic rub), respondents know the way of hand disinfection after exposition to blood the best (76.8%), while the method of disinfection after touching a patient’s environment the least (31%). Knowledge about hand hygiene varies between workers, depending on their occupation and their place of work. Our study shows those areas, where knowledge about hand hygiene must be advanced.

Hand hygiene knowledge among undergraduate medical students in Junagadh, Gujarat, India

Background: Hand hygiene is now regarded as one of the most important element of infection control activities. Medical students in their clinical training phase throng the healthcare facilities and can potentially transmit infections besides being the healthcare providers of future when their pattern of training will reflect on their infection control practices. Therefore, this study was carried out to assess the knowledge of undergraduate medical students regarding hand hygiene practices.Methods: A cross-sectional study was carried out and data was collected by using “WHO hand hygiene knowledge questionnaire for health care workers” among 2nd M.B.B.S medical students at Junagadh. Knowledge was graded as good, moderate or poor based on the total number of correct answers.Results: Total 123 students participated in the study. There were 65 (53%) females and 58 (47%) were males. The mean hand hygiene knowledge score (out of 25) was 15.05 (SD: ±2.37, 95% CI: 14.63-15.48). Majority of the participants (76%) had moderate knowledge of hand hygiene practices.Conclusions: In the present study majority of the students had not received formal training regarding hand hygiene practices. Majority of the students had moderate knowledge of hand hygiene. Incorporation of teaching and training of hand hygiene practice in the undergraduate teaching during the initial study years is the need of the hour to prevent further emergence of antimicrobial resistance and health care associated infections.

Hand hygiene knowledge and attitude of medical students in western Saudi Arabia.

BackgroundThe practice of hand hygiene (HH) has prime importance among Health Care Professionals (HCPs) and non-compliance could cause adverse consequences. By keeping the importance of HH in mind, this study aims at investigating the knowledge and attitudes towards HH among medical students and interns at King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA).MethodsThe study includes 453 medical students and interns (189 males & 264 females). This study was completed in three months; from September to November 2017. The World Health Organization (WHO) HH questionnaire was used and data were analyzed on SPSS-21.ResultsTwo-third of the participants 292 (64.2%) had formal training in HH in the last three years. Almost half of the participants 254 (56.1%) had correct knowledge regarding the major course of transmission of potentially detrimental microbes among patients in the healthcare premises. Just 124 (27.4%) of the respondents had the correct knowledge about the most common basis of germs accountable for healthcare-related infections. Females had significantly better knowledge than males regarding the type of HH technique needed before palpation of the abdomen (177(54%) Vs. 151(46%); P < 0.002), before an injection (175(54.5%) Vs. 146(45.5%); P < 0.007), after emptying a bedpan (207(64.7%) Vs. 113(35.3%); P < 0.001), following discarding examination gloves (256(60.4% Vs. 168(39.6%); P < 0.001] and after exposure to blood (200(64.1%) Vs. 112(35.%); P < 0.001). Female participants had better knowledge than males regarding the type of HH actions. Females also had a significantly better attitude towards the importance of HH than males (240(62.5%) Vs. 144(37.5%); P < 0.001).ConclusionThe majority of the participants’ knowledge regarding HH was not up to the mark; however, female students had better knowledge compared to male students. The medical students and interns’ knowledge and positive attitude towards HH can play a pivotal role in preventing HCPs associated infections and it would overall decrease the infection-related burden on the hospital and governmental budgets. It is suggested that multi-dimensional plans are required to change this low compliance to a higher rate.

Epidemiological investigation on hand hygiene knowledge and behaviour: a cross-sectional study on gender disparity

BackgroundThe hand hygiene (HH) behaviour of the general public and its effect on illnesses are issues of growing importance. Gender is associated with HH behaviour. HH efficiency is a combination of washing efficiency and hand drying, but information about the knowledge level and HH behaviour of the general public is relatively limited. The findings of this cross-sectional study can substantially contribute to the understanding on the knowledge gap and public behaviour towards HH, thereby providing information on gender-specific health promotion activities and campaigns to improve HH compliance.MethodsAn epidemiological investigation by using a cross-sectional study design on the general public was conducted either via an online platform (SurveyMonkey) or paper-and-pen methods. The hand-washing and -drying questionnaire was used for data collection.ResultsA total of 815 valid questionnaires were collected. Majority of the respondents can differentiate the diseases that can or cannot be transmitted with poor HH, but the HH knowledge of the respondents was relatively inadequate. The female respondents had a significantly better HH knowledge than male respondents. The multiple regression analysis results also indicated that females had a significantly higher knowledge score by 0.288 towards HH than males after adjusting for age and education level. Although the majority of the respondents indicated that they performed hand cleaning under different specific situations, they admitted only using water instead of washing their hands with soap. More males than females dried their hands on their own clothing, whereas more females dried their hands through air evaporation. The average time of using warm hand dryers was generally inadequate amongst the respondents.ConclusionsBeing a female, middle-aged and having tertiary education level are protective factors to improve HH knowledge. Misconceptions related to the concepts associated with HH were noted amongst the public. Self-reported practice on hand drying methods indicated that additional education was needed. The findings of this study can provide information on gender-specific health promotion activities and creative campaigns to achieve sustained improvement in HH practices.

Visibility and transmission: complexities around promoting hand hygiene in young children \u2013 a qualitative study

BackgroundEffective hand hygiene practice can reduce transmission of diseases such as respiratory tract infections (RTIs) and gastrointestinal infections, especially in young children. While hand hygiene has been widely promoted within Australia, primary care providers’ (PCPs) and parents’ understanding of hand hygiene importance, and their views on hand hygiene in reducing transmission of diseases in the community are unclear. Therefore, the aim of this study was to explore the views of PCPs and parents of young children on their knowledge and practice of hand hygiene in disease transmission.MethodsUsing a cross-sectional qualitative research design, we conducted 30 in-depth interviews with PCPs and five focus groups with parents (n = 50) between June 2014 and July 2015 in Melbourne, Australia. Data were thematically analysed.ResultsParticipants agreed that hand hygiene practice was important in reducing disease transmissions. However, barriers such as variations of hand hygiene habits, relating visibility to transmission; concerns around young children being obsessed with washing hands; children already being ‘too clean’ and the need to build their immunity through exposure to dirt; and scepticism that hand hygiene practice was achievable in young children, all hindered participants’ motivation to develop good hand hygiene behaviour in young children.ConclusionDespite the established benefits of hand hygiene, sustained efforts are needed to ensure its uptake in routine care. To overcome the barriers identified in this study a multifaceted intervention is needed that includes teaching young children good hand hygiene habits, PCPs prompting parents and young children to practice hand hygiene when coming for an RTI consultation, reassuring parents that effective hand hygiene practice will not lead to abnormal psychological behaviour in their children, and community health promotion education campaigns.