Hand Hygiene Knowledge Research Articles

Hand hygiene knowledge and practices among healthcare providers in a tertiary hospital, South West Nigeria

ABSTRACT Proper hand hygiene is an important means of preventing nosocomial infections. This study aimed to assess knowledge, attitude and hand hygiene practices among healthcare providers (HCPs) in Lagos University Teaching Hospital (LUTH), Lagos, South-West Nigeria. A cross-sectional study was conducted in August, 2011. Simple random sampling was used to select 500 HCPs (250 doctors and 250 nurses). Data collection was done with self-administered, structured questionnaires. Data obtained were analyzed with Epi-info 2008. A total of 430 HCPs (230 doctors and 200 nurses) participated in this study giving a response rate of 86%. Eighty-three percent had good knowledge; 97.6% had good attitude and 69.9% had good hand washing practices. Hand washing after contact with patient (97.7%) was better than before contact (61.4%). Nurses had better hand washing practices than doctors (Fisher’s exact p<0.001) and were more likely to wash their hands before patient contact than doctors (p<0.001). Training on infection control had a significant positive influence on HCPs knowledge and hand washing practices (Fisher’s exact p<0.001 and Fisher’s exact p<0.001) respectively. The commonly used hand-drying methods were common cloth towel (22.6%) and natural air drying (29.5%). The major motivation for hand washing was fear of contracting disease while the major constraint was busy work schedule in-between patient care. HCPs in LUTH have good hand washing knowledge but suboptimal practices especially with hand-drying. Hospital management should provide proper hand drying facilities, reduce work load and organize training on infection control on a regular basis. Key words: Infection control; hand washing; patient care; practice; healthcare providers; Nigeria

Hand hygiene knowledge and practices among healthcare providers in a tertiary hospital, south west, Nigeria

Hand hygiene knowledge and practices among healthcare providers in a tertiary hospital, south west, Nigeria

The search for an evidence-based intervention to improve hand hygiene compliance in a residential aged care facility

Healthcare-acquired infections are a major source of morbidity and mortality in people living in residential aged care facilities. Compliance with hand hygiene by healthcare workers can reduce the risk of infection to residents, yet compliance rates are generally low. Infection-control advocates within the aged care sector are looking to conduct programs to improve rates among their staff. This review was conducted to identify a reproducible intervention to improve staff hand hygiene compliance within an Australian residential aged care facility. Medline, Embase, and CINAHL databases were searched for combinations of ‘hand hygiene’, ‘hand washing’, ‘residential aged care facility’, ‘aged care’, ‘nursing home’ and ‘long-term care facility’ from 2000 to current. Articles were excluded if the information was not clearly stated as pertaining to a residential aged care facility or if the data investigated staff knowledge or perceptions of hand hygiene. Most of the five articles included in the review reported an improvement in compliance rates. Studies were multimodal, had an education or training component, and included the promotion of alcohol-based hand rubs. Several used aspects of the World Health Organization's hand hygiene initiatives. Compliance audit tools across the studies were not consistent; thus, results may not be comparable. There are few published studies which report interventions that improve hand hygiene compliance among healthcare workers within residential aged care facilities. Successful studies included the promotion of alcoholbased hand rubs. More research is needed to improve hand hygiene compliance in the aged care sector.

병원실습 경험이 있는 간호 대학생의 손 위생 지식과 이행에 관한 연구

Purpose: The goal of the study was to investigate nursing students` knowledge and compliance with hand hygiene to find out the variables associated with compliance with hand hygiene. Methods: The participants were 1,020 nursing college students located in Seoul, Ansan and Suncheon. The variables analyzed in this study were; hand hygiene knowledge, hand hygiene compliance, hand washing habits, hand hygiene education with emphasis in school, emphasis on hand washing and role modeling in hospital, and hand hygiene beliefs. Data were analyzed by frequency, -test, t-test and Pearson correlation coefficient. Results: 1. The correct answer average percentage of hand hygiene knowledge was 78.4%. 2. The average rates of hand hygiene compliance rate was 78.0% 3. Compliance rate had significant correlation with variables such as hand washing habit, hand hygiene education with emphasis in school, emphasis on hand washing and role modeling in hospital, and hand hygiene belief. Conclusion: 1. It is nessassery for nursing students to receive proper educational on hand hygiene knowledge during practices in nursing school curriculum. 2. Nurses should be encouraged to be a good mentor to nursing students on appropriate hand hygiene compliance in clinical practice.

Mind the mind: Results of a hand-hygiene research in a state-of-the-art cancer hospital

Poor hand-hygiene (HH) is the primary cause of health-care related infections, yet compliance has proven to be challenging. This multi-method study into HH in a state-of-the-art cancer hospital demonstrates that the presence of resources and prioritisation of HH alone is not sufficient for HH compliance. A large gap was found between perceived (87%) and actual (52%) HH compliance and knowledge. Similarly, although 82% of the respondents knew proper HH moments, they did not act on it. These gaps between perception and reality suggest that resources, knowledge and training might not be sufficient for improving HH: Psychological barriers need to be addressed too.

Handwashing behaviour among Chinese adults: a cross-sectional study in five provinces

ObjectivesTo describe the patterns of handwashing behaviour among Chinese adults, and assess their associations with sociodemographic factors and knowledge of hand hygiene. Study designA representative sample (n = 6159) of Chinese adults aged 18–60 years in five provinces was attained by multiple-stage, stratified sampling mainly based on geographical location and economic status. Data on handwashing behaviour, knowledge of hand hygiene and sociodemographic factors were collected through self-administrated questionnaires. MethodsAssociations between handwashing behaviour and sociodemographic factors were tested in logistic models. Path analysis was applied to examine the associations between sociodemographic factors, knowledge of hand hygiene and proper handwashing behaviour in order to evaluate the relative magnitude of these determinants and internal relationships. ResultsThis study found that 52.7% (rural vs urban: 44.6% vs 56.8%) and 67.3% (rural vs urban: 59.7% vs 71.1%) of Chinese adults reported they always washed hands before eating and after defaecation, and 30.0% (rural vs urban: 25.1% vs 32.8%) of adults always used soap or other sanitizers during washing. Using the criteria of ‘always or very often washing hands with soap before eating and after defaecation without sharing a towel with family members after washing’, only 47.2% (rural vs urban: 23.8% vs 59.1%) of the adults were graded to practice proper handwashing behaviour. Urban area, high level of education level, high level of knowledge about diseases, female gender and older age were protective factors for good hand hygiene; of these, area was found to be associated most strongly with handwashing behaviour. ConclusionsAdherence to an appropriate handwashing method and duration of handwashing are critical problems among Chinese adults. Area difference, level of education and level of knowledge of hand hygiene were most strongly associated with handwashing behaviour, and should be targeted in future health education.

P175: A new training and assessment support of knowledge in hand hygiene: CD - ROM type quiz prepared by the Department of Health Bizerte

The year 2010 has been very prolific in Tunisia with regard to educational materials and training on hand hygiene: brochures, pamphlets, fact sheets, slide shows, quizzes, ... All these documents were developed by teams of volunteers and designed inspired by the WHO documentation issued in 2009 (adoption after adaptation). They were gathered in a toolbox hand hygiene. The Department of Hygiene Bizerte participated in enriching the content of this toolkit for the development of a CD-ROM training and knowledge assessment of hand hygiene.

Patient empowerment in a hand hygiene program: Differing points of view between patients/family members and health care workers in Asian culture

"Patient empowerment" is an important component of World Health Organization hand hygiene program, but little is known about the intentions and attitude of patients/families and health care workers (HCWs) regarding this. A cross-sectional survey using questionnaires was conducted in a tertiary teaching hospital in Taiwan to assess hand hygiene knowledge and the attitudes and intentions regarding patient empowerment among patients/families and HCWs. Among patients/families, 95.4% (329/345) had positive attitudes regarding patient empowerment; however, only 67.2% (232/345) had the positive intention to remind HCWs about hand hygiene (P < .001). Risk factors for negative intention were being female (odds ratio [OR], 1.82; 95% confidence interval [CI]: 1.08-3.03), illiteracy (OR, 3.18; 95% CI: 0.86-11.7), and being patients/families in the pediatric department (OR, 1.86; 95% CI: 0.93-3.64). Among HCWs, the difference between positive attitude (81.1%; 714/880) and positive intention regarding being reminded about hand hygiene (62.8%; 553/880) was significant (P < .001). Risk factors for negative intention were age > 25 years (OR, 3.20; 95% CI: 1.51-6.81) and a negative attitude toward patient empowerment (OR, 10.00; 95% CI: 5.88-16.67). There were significant gaps between attitude and intention regarding patient empowerment both among patients/families and HCWs. Special strategies targeting women, the pediatric population, or illiterate people may help improve patient/family participation. Additionally, hand hygiene education should be incorporated into early-stage medical/nursing education to create a facilitating environment. Patients/families and HCWs cooperation is needed to promote the hand hygiene program further.

Hand hygiene knowledge, attitudes and practices among food handlers at primary schools in Hulu Langat district, Selangor (Malaysia)

The purpose of this study was to investigate the hand hygiene knowledge, attitudes and practices of food handlers from 38 primary schools in Hulu Langat district, Selangor State in Malaysia. Hand hygiene knowledge, principally regarding ready-to-eat foods, the existence of bacteria and correct hand-washing methods were lacking among the food handlers. From the observations reported herein, the use of masks and hand-washing with proper technique were neglected by most food handlers. In the demographic profile analysed, there were significant differences (p ≤ 0.05) in the following areas: hand-washing practices between genders (p = 0.039), hand hygiene attitudes and glove use between nationalities (p = 0.002 and p = 0.029, respectively); and personal hygiene knowledge between groups with different levels of education (p = 0.048). This study revealed a slightly positive relationship between hand hygiene knowledge and self-reported practices of food handlers (r = 0.249, p = 0.022). The results showed that further continuous effort should be invested in hand hygiene education and enforcement for food handlers from primary schools in the Hulu Langat district. This study provided data about the current knowledge, attitudes and practices of food handlers from institutional foodservice operations in Malaysia regarding hand hygiene.

Effects of Knowledge and Internal Locus of Control in Groups of Health Care Workers Judging Likelihood of Pathogen Transfer

A study was conducted to measure the effects of attitudes and beliefs on the risk judgments of health care workers. Lack of hand hygiene compliance is a worldwide issue in health care, contributing to infections, fatalities, and increased health care costs. Human factors methods are a promising solution to the problem of compliance, although thus far, the concentration has been on process and engineering methods, such as the design of no-touch sinks. Factors internal to the health care worker, such as their attitudes and beliefs about hand hygiene, have received less attention. For this study, three groups of health care workers completed measures of attitudes, control beliefs, and hand hygiene knowledge. They then provided risk judgments of touching various surfaces via a factorial survey. Attitudes, knowledge, control beliefs, and surface type all predicted the risk judgments of the sample of health care workers, with differences between professional groups. Health care workers perceive less risk when touching surfaces,which may explain historically low rates of hand hygiene compliance after surface contact. Although more research is needed to directly connect risk judgments to failures of hand hygiene, the current results can inform interventions targeting the internal attitudes and beliefs of health care workers.

Knowledge, attitudes and practices of hand hygiene among final year medical and nursing students at the University of Sri Jayewardenepura

The Sri Lankan Journal of Infectious Diseases (SLJID) is an open access, peer-reviewed, biannual journal published by the Sri Lankan Society for Microbiology (SSM). The Journal considers articles from all professional disciplines involved in the field of infectious diseases. The Journal has been in publication since 2011, is included in the DOAJ since 2018 and is a member of COPE since 2021. The SLJID practices a double-blind peer review policy. From 2022, the SLJID publishes accepted manuscripts online immediately after copy-editing, enabling rapid dissemination of scientific knowledge. The published articles are subsequently compiled into two issues in April and October. The SLJID does not charge any article processing or publication fee.

P143: Teaching the concepts of hand hygiene to undergraduate medical students: the views of key stakeholders

Currently, hand hygiene (HH) compliance rates amongst Australian medical students are below 70% nationally. Previous attempts to improve medical students’ knowledge of HH have had only short-term successes with follow-up studies reporting poor long-term retention of knowledge worldwide. It has been previously suggested that the importance of HH must be taught to medical students from the first year and integrated into their clinical curricula.

Hand hygiene practices among doctors in a tertiary health facility in southern Nigeria

Background: Hand washing is a cheap and effective method of limiting the spread of health care associated infections, but compliance has been reported to be low worldwide, especially in developing countries. Objective: To determine the knowledge and practice of hand hygiene among doctors in a tertiary health facility in southern Nigeria. Materials and Methods: This cross-sectional, descriptive study was carried out among all cadres of doctors employed by the hospital. Data were collected using a pretested, semistructured, self-administered questionnaire as well as by direct observation of a subsample of the doctors using an observational checklist. Data analysis was done using the SPSS version 16.0 statistical package and level of significance was set at P Results: A total of 326 doctors participated in the study and one third of these (108) were directly observed. Less than half of the respondents had good knowledge (43.9%) and good practice (48.2%) of hand hygiene. However, on direct observation, the overall compliance rate was 16.7%. Sex and specialty of the respondents were significantly associated with knowledge but not with practice of hand hygiene. The reasons mentioned for noncompliance included: Lack of hand hygiene materials like soap and water (65.0%), forgetfulness (35.0%), too busy/insufficient time (19.3%), inconvenient location of sinks (16.9%), the use of gloves (7.1%), and skin irritation from washing agents (4.6%). Conclusion: This study revealed a very low hand hygiene compliance rate among doctors in a tertiary health facility in the southern part of Nigeria and also highlighted some of the contributory factors. It is recommended that an institution-wide hand hygiene promotion campaign be embarked upon.

Level of Knowledge and Practice on Hand Hygiene among Student Nurses in Selected Paediatric Hospital at Mangalore

A non-experimental descriptive study was undertaken to determine the level of knowledge and practice on hand hygiene among the student nurses. A total of 60 student nurses were selected using convenience sampling technique. A structured questionnaire and an observation checklist were developed and validated to collect the data. The results revealed that 53.3 percent of student nurses had good level of knowledge and 60 percent of student nurses had an average level of practice on hand hygiene. No significant association was found between level of knowledge and practice on hand hygiene and demographic variables such as age of the students, gender, year of study, type of nursing course attended on hand hygiene. A significant positive correlation was found between knowledge and practice scores of hand hygiene among student nurses. It is concluded that the student nurses who had high knowledge scores had better practice as compared to those with poorer scores.

HAND HYGIENE;

Background: WHO Guidelines recommends ‘‘My five moments for hand hygiene” for prevention of HCAI. Objective: Toassess the knowledge and practices of medical students about HCAI and hand hygiene. Setting: Lahore Medical &amp; Dental College(LMDC), Lahore. Period: Four weeks, in January and February, 2012. Methods: Descriptive cross-sectional study was conducted usingWHO’s “Hand Hygiene Knowledge Questionnaire”, among MBBS students from 3rd to final years, 2012. Data was entered and cleaned inSPSS 19 and presented in tables and graphs. Descriptive statistics was used in the forms of numbers and percentages. Results: Among227 respondents, 63% were female, 67% were 20 to 22 years old, 38% were from 3rd year, 40% from 4th year and 22% from final year,61% never received hand hygiene training and 67% never used hand rubs. Few students named unclean hands as main route (42%) andsource of HCAI (21%). Hand hygiene was preferred before touching patients (76%) and after body fluid exposure (70%). It was perceivedto be rapid (63%), effective (66%), cause of skin dryness (57%) and it was supposed to be used concomitantly with hand washing (74%),before abdomen palpation (48%), giving injection (31%), after removing gloves (22%) and making patient’s bed (31%). Damaged skin(92%), artificial fingernails (78%) and jewelry (53%) were perceived to increase hand contamination. Conclusions: There were seriousgaps in knowledge of proper hand cleaning techniques and their importance in prevention of health HCAI. Hand hygiene, must be part ofcurriculum and training of all health care providers.

손위생 교육프로그램이 간호대학생의 손위생 지식, 손위생 인식, 비강 내 황색포도알균 집락 및 손위생 이행에 미치는 효과

Purpose: This study was conducted to test the effect of the Hand Hygiene Education Program on hand hygiene knowledge, hand hygiene perception, nasal Staphylococcus aureus colonization and hand hygiene adherence in nursing students. Methods: A nonequivalent pre-post test of quasi-experimental design was used. 87 second grade nursing students participated in the study with 43 in the experimental group and 44 in the control group. We used the Hand Hygiene Education Program which was held 5 times over 5 weeks, taking 60 minutes per session. For the analysis, descriptive statistics, chi test, and t-test were used for statical analysis with SPSS 19.0. Results: There were significant increases in hand hygiene knowledge ( p = .004) and hand hygiene adherence (p = .002) and there was a significant decrease in nasal Staphylococcus aureus colonization (p = .026) in the experimental group compared to the control group. However, hand hygiene perception (p = .543) was not significantly changed. Conclusion: Findings of this study suggest that the Hand Hygiene Education Program may be effective in enhancing hand hygiene knowledge and hand hygiene ad herence. Also this program was effective in reducing nasal Staphylococcus aureus colonization in nursing students. Further studies are needed to evaluate the effects of the Hand Hygiene Education Program on hand hygiene perception in nursing students.

Hand hygiene knowledge and practices of nursing students in Singapore

Hand hygiene is an important means of preventing nosocomial infections. Studies have shown a <50% compliance rate for hand hygiene among health care workers. A hand hygiene survey was administered to nursing students in a tertiary institution in Singapore. The results of this survey strongly indicate that nursing students understand the importance of hand hygiene compliance and perceive clinical internship programs and practical laboratory sessions to be effective methods of hand hygiene education.

Meta-analysis of food safety training on hand hygiene knowledge and attitudes among food handlers.

Research has shown that traditional food safety training programs and strategies to promote hand hygiene increases knowledge of the subject. However, very few studies have been conducted to evaluate the impact of food safety training on food handlers' attitudes about good hand hygiene practices. The objective of this meta-analytical study was to assess the extent to which food safety training or intervention strategies increased knowledge of and attitudes about hand hygiene. A systematic review of food safety training articles was conducted. Additional studies were identified from abstracts from food safety conferences and food science education conferences. Search terms included combinations of "food safety," "food hygiene," "training," "education," "hand washing," "hand hygiene," "knowledge," "attitudes," "practices," "behavior," and "food handlers." Only before- and after-training approaches and cohort studies with training (intervention group) and without training (control group) in hand hygiene knowledge and including attitudes in food handlers were evaluated. All pooled analyses were based on a random effects model. Meta-analysis values for nine food safety training and intervention studies on hand hygiene knowledge among food handlers were significantly higher than those of the control (without training), with an effect size (Hedges' g) of 1.284 (95% confidence interval [CI] ∼ 0.830 to 1.738). Meta-analysis of five food safety training and intervention studies in which hand hygiene attitudes and self-reported practices were monitored produced a summary effect size of 0.683 (95% CI ∼ 0.523 to 0.843). Food safety training increased knowledge and improved attitudes about hand hygiene practices. Refresher training and long-term reinforcement of good food handling behaviors may also be beneficial for sustaining good hand washing practices.

The short-term and long-term effectiveness of a multidisciplinary hand hygiene improvement program

Although hand hygiene (HH) compliance has been an important issue for years, the compliance rate is still a problem in health care today. This was an observational, prospective, before-and-after study. We measured HH knowledge and HH compliance before (baseline), directly after (poststrategy), and 6 months after the performance of HH team strategies (follow-up). The study was composed of employed nurses and physicians working in the department of internal medicine of a university hospital. We performed a multifaceted improvement program including HH education, feedback, reminders, social influence activities including the use of role models, and improvement of HH facilities. Ninety-two nurses and physicians were included. Compared with baseline, there was a significant improvement in the overall mean HH knowledge score at poststrategy (from 7.4 to 8.4) and follow-up (from 7.4 to 8.3). The overall HH compliance was 27% at baseline, 83% at poststrategy, and 75% at follow-up. At baseline, the compliance rate was 17% in nurses and 43% in physicians and significantly improved to 63% in nurses and 91% in physicians at follow-up. Our multifaceted HH improvement program resulted in a sustained improvement of HH knowledge and compliance in nurses as well as physicians.

Effectiveness of Hand Hygiene Education in a Basic Nursing School Curricula

Although hand hygiene (HH) is the cheapest and simplest tool for the prevention of hospital-acquired infections, poor HH compliance has been reported among health care professionals. A variety of factors influence the compliance with HH guidelines, the most important being the quality of the basic nursing education. The aims of this study were to analyze the effectiveness of the basic nursing education in relation to HH, and to explore the skills and attitudes toward HH among nursing students in praxis. A mixed-method approach using a cross-sectional survey combined with observation and curricular analysis was used. A total of 188 nursing students participated in the study. Content analysis revealed significant deficits in the quality of HH-related information in basic nursing educational programs. Our results correlate directly with the reported insufficient levels of HH knowledge and the associated poor HH compliance by students during their training in clinical settings; as shown in observation and questionnaire-based surveys. The lack of compliance with HH standards among students lead to poor compliance among health care professionals in praxis. Consequently, the role of educational institutions in the prevention of hospital-acquired infections is significant, if the effectiveness of HH education is to be improved.