Comparison of Perceived and Observed Hand Hygiene Compliance in Healthcare Workers in MERS-CoV Endemic Regions

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.

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Hand hygiene compliance among rural healthcare workers of Nepal

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v5i1.24050 ◽

2018 ◽

Vol 5 (1) ◽

pp. 90-95

Author(s):

Ajay Kumar Rajbhandari ◽

Reshu Agrawal Sagtani ◽

Kedar Prasad Baral

Keyword(s):

Health Care ◽

Hand Hygiene ◽

Healthcare Workers ◽

Compliance Rate ◽

Hand Washing ◽

World Health ◽

Cross Sectional ◽

Hygiene Compliance ◽

Health Organization ◽

Healthcare Associated

Introductions: Transmission of healthcare associated infections through contaminated hands of healthcare workers are common. This study was designed to explore the existing compliance of hand hygiene among the healthcare workers workings in different level of health care centers of Makwanpur district of Nepal. Methods: This was a cross sectional observational study conducted in Makwanpur district, Nepal, during 2015. Healthcare workers from nine healthcare centers were selected randomly for the study. Standard observation checklists and World Health Organization guidelines on hand hygiene were used to assess the compliance of hand hygiene during patient care. Results: There were 74 participants. Overall compliance for hand washing was 24.25% (range 19.63 to 45.56). Complete steps of hand washing were performed by 38.3% of health care workers. The factors associated for noncompliance were lack of time (29.3%), example set by seniors (20%), absence or inadequate institution protocol (20%) and unfavourable health care setting (> 20%). Conclusions: Overall hand washing compliance rate amongst the healthcare workers in rural health facilities of Nepal were low (24.25%).

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

The Journal of Infection in Developing Countries ◽

10.3855/jidc.10916 ◽

2019 ◽

Vol 13 (08) ◽

pp. 744-747 ◽

Cited By ~ 1

Author(s):

Uluhan Sili ◽

Pinar Ay ◽

Huseyin Bilgin ◽

Seyhan Hidiroglu ◽

Volkan Korten

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hand Hygiene ◽

Healthcare Workers ◽

Compliance Rate ◽

Cross Sectional Study ◽

University Hospital ◽

World Health ◽

Training Methods ◽

Cross Sectional

Introduction: 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. Methodology: 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. Results: 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. Conclusions: 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.

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Hand Hygiene Knowledge and Perception among the Healthcare Workers during the COVID-19 Pandemic in Qassim, Saudi Arabia: A Cross-Sectional Survey

Healthcare ◽

10.3390/healthcare9121627 ◽

2021 ◽

Vol 9 (12) ◽

pp. 1627

Author(s):

Adil Abalkhail ◽

Ilias Mahmud ◽

Fahad A. Alhumaydhi ◽

Thamer Alslamah ◽

Ameen S. S. Alwashmi ◽

...

Keyword(s):

Saudi Arabia ◽

Hand Hygiene ◽

Healthcare Workers ◽

Primary Source ◽

Cross Sectional Study ◽

World Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Government ◽

Health Organization

Hand hygiene is among the most important factors of infection control in healthcare settings. Healthcare workers are the primary source of hospital-acquired infection. We assessed the current state of hand hygiene knowledge, perception, and practice among the healthcare workers in Qassim, Saudi Arabia. In this cross-sectional study, we used the hand hygiene knowledge and perception questionnaire developed by the World Health Organization. Knowledge and perceptions were classified into good (80–100%), moderate (60–79%), and poor (<60% score). The majority of the healthcare workers had moderate knowledge (57.8%) and perception (73.4%) of hand hygiene. Males were less likely to have moderate/good knowledge compared to females (OR: 0.52, p < 0.05). Private healthcare workers were less likely (OR: 0.33, p < 0.01) to have moderate/good perceptions compared to the government healthcare workers. Healthcare workers who received training on hand hygiene were more likely to have good/moderate perception (OR: 3.2, p < 0.05) and to routinely use alcohol-based hand rubs (OR: 3.8, p < 0.05) than the ones without such training. Physicians are more likely (OR: 4.9, p < 0.05) to routinely use alcohol-based hand rubs than technicians. Our research highlighted gaps in hand hygiene knowledge, perception and practice among healthcare workers in Qassim, Saudi Arabia and the importance of training in this regard.

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Compliance of Healthcare Workers with Hand Hygiene Practices in Neonatal and Pediatric Intensive Care Units: Overt Observation

Interdisciplinary Perspectives on Infectious Diseases ◽

10.1155/2014/306478 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 18

Author(s):

Ayşe Karaaslan ◽

Eda Kepenekli Kadayifci ◽

Serkan Atıcı ◽

Uluhan Sili ◽

Ahmet Soysal ◽

...

Keyword(s):

Intensive Care ◽

Hand Hygiene ◽

Healthcare Workers ◽

Pediatric Intensive Care ◽

University Hospital ◽

World Health ◽

Routine Patient Care ◽

Hygiene Practices ◽

Health Organization ◽

Observation Period

Background.The objective of this study was to assess the compliance of hand hygiene (HH) of healthcare workers (HCWs) in the neonatal and pediatric intensive care unit in a tertiary university hospital in Istanbul.Methods.An observational study was conducted on the compliance of HH for the five World Health Organization (WHO) indications. HCWs were observed during routine patient care in day shift. The authors also measured the technique of HH through hand washing or hand hygiene with alcohol-based disinfectant.Results.A total of 704 HH opportunities were identified during the observation period. Overall compliance was 37.0% (261/704). Compliance differed by role: nurses (41.4%) and doctors (31.9%) [P=0.02, OR: 1.504, CI 95%: 1.058–2.137]. HCWs were more likely to use soap and water (63.6%) compared to waterless-alcohol-based hand hygiene (36.3%) [P<0.05].Conclusion.Adherence to hand hygiene practice and use of alcohol-based disinfectant was found to be very low. Effective education programs that improve adherence to hand hygiene and use of disinfectants may be helpful to increase compliance.

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Knowledge, Perception, and Performance of Hand Hygiene and Their Correlation among Nursing Students in Republic of Korea

Healthcare ◽

10.3390/healthcare9070913 ◽

2021 ◽

Vol 9 (7) ◽

pp. 913

Author(s):

Hyang Soon Oh

Keyword(s):

Nursing Education ◽

Clinical Practice ◽

Nursing Students ◽

Hand Hygiene ◽

Healthcare Workers ◽

Final Analysis ◽

World Health ◽

Cross Sectional ◽

And Performance ◽

Health Organization

Recently, various outbreaks of newly emerging or reemerging diseases are expected more frequently and regularly. The importance of hand hygiene (HH) competency of nursing students (NS) is further required as a crucial learning objective of nursing education in universities. Purpose: This study aimed to investigate knowledge, perception, and performance of HH among NS and analyze their correlation. Methods: A cross-sectional questionnaire (modified from a World Health Organization questionnaire) was conducted from 23 November to 22 December 2019; 233 responses were used for the final analysis. Results: The average scores (mean ± standard deviation (range)) for knowledge, perception, and performance of HH were 17.82 ± 2.15 (0–25), 77.24 ± 10.78 (15–96), and 67.42 ± 23.10 (0–100), respectively. No significant variables were discovered to the knowledge of HH. Grade, university-affiliated hospitals, and the most recent healthcare institute of clinical practice nursing course significantly affected perceptions of HH (p < 0.039, p = 044, p < 0.001). Knowledge of HH was positively correlated with performance of HH (p = 0.002). The perception and the performance of HH of NS were positively correlated with HH performance of healthcare workers (HCWs); p < 0.001, p = 0.002. Conclusion: HH education for NS is crucial for improving the performance and the knowledge of HH. Good HH performance of healthcare workers (HCWs) can contribute to increased perception and performance of HH among NS. The cooperation of nursing education in a university and clinical practice with competent HCWs in healthcare institutions may create an effective education program for good HH performance of NS, who will be nurses during unpredictable pandemics.

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Compliance of Healthcare Workers with Hand Hygiene Practices in the Northeast of Iran: An Overt Observation

International Journal of Public Health Science (IJPHS) ◽

10.11591/ijphs.v7i4.14191 ◽

2018 ◽

Vol 7 (4) ◽

pp. 289

Author(s):

Reza Vafaei Nezhad ◽

Atieh Yaghoubi ◽

Kiarash Ghazvini

Keyword(s):

Hand Hygiene ◽

Healthcare Workers ◽

Health Workers ◽

Intervention Programs ◽

World Health ◽

Clinical Settings ◽

Affecting Factors ◽

Hygiene Practices ◽

Observation Method ◽

Health Organization

Hand hygiene (HH) is one of the most effective methods to prevent transmission and spread of microorganisms from one patient to another, also, it used to reduce the spread of pathogens in clinical settings and to help control outbreaks but compliance is usually poor. The purpose of this study was to analyze the compliance of hand hygiene and affecting factors among healthcare workers (HCWs) of northeast hospitals in Iran. This study was conducted based on observation method for the compliance of hand hygiene according to the World Health Organization (WHO) guidelines. HCWs were observed during routine patient care in different shifts, also the technique of hand hygiene was assessed through hand washing with alcohol-based disinfectant. Data were collected during 1 year, from June 2014 to July 2015 by the infection control teams in the northeast hospital of Iran. By direct observation, we evaluated a total of 92518 hand hygiene opportunities from 29 hospitals in the northeast of Iran during 1 year, with overall compliance rates in these hospitals were 43.42%. Compliance rates differed by role: nurses43%, doctors 19 % and other health workers 29%. In this observational study, we identified that adherence to hand hygiene practice and use of alcohol-based disinfectant was very low in this hospitals, so effective intervention programs to promote adherence to hand hygiene and use of disinfectants could be effective to increase compliance.

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Reported healthcare workers knowledge and practices of hand hygiene in specialist hospitals of Kano, Northwest Nigeria

Pyramid Journal of Medicine ◽

10.4081/pjm.2020.78 ◽

2021 ◽

Vol 3 (2) ◽

Author(s):

Auwal Umar Gajida ◽

Usman Muhammad Ibrahim ◽

Rabiu Ibrahim Jalo ◽

Musa Muhammad Bello ◽

Amole Taiwo Gboluwaga ◽

...

Keyword(s):

Hand Hygiene ◽

Healthcare Workers ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Formal Training ◽

Drug Resistant ◽

Improve Hand Hygiene ◽

Cross Sectional ◽

Hygiene Practices ◽

Self Administered Questionnaire

Compliance with recommended hand hygiene among healthcare providers is important in the prevention of morbidity and mortality associated with hospitalacquired infections including drug resistant microorganisms. This study aimed to determine the reported knowledge and hand hygiene practices among healthcare workers in Specialist Hospitals in Kano, Nigeria. Descriptive cross-sectional study design was used to study 302 healthcare workers in the specialist hospitals in Kano. Data was collected using semi-structured self-administered questionnaire and analyzed at univariate, bivariate and multivariate levels using IBM SPSS version 22. The age of the respondents ranged from 18 to 59 years with a mean of 31.4±9 years. Up to onethird (36.1%) of the respondents had poor knowledge despite the reported hand hygiene practice of 78%. Use of Alcohol Based Hand Rub and soap and water constituted 26.7% and 15.7% respectively. There was statistically significant association between working in MMSH, working in Pediatrics wards, CHEW cadre, and attendance of hand hygiene training in the last 3 years and having good knowledge of hand hygiene. Hand hygiene training was found to improve hand hygiene knowledge [AOR=1.58, 95% CI= (1.01-2.5)] and practice [AOR=1.12 95%CI= (0.64-1.99)]. Reported knowledge of hand hygiene was poor but the practices were encouraging and associated with formal training of healthcare workers on hand hygiene. Therefore, Hospital management should ensure regular hand hygiene training and re-training among healthcare workers.

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Hand Hygiene Knowledge and Perception Among the Healthcare Workers During the COVID-19 Pandemic in Qassim, Saudi Arabia: A Cross-Sectional Survey

10.20944/preprints202110.0435.v1 ◽

2021 ◽

Author(s):

Adil Abalkhail ◽

Ilias Mahmud ◽

Fahad A. Alhumaydhi ◽

Thamer Alslamah ◽

Ameen S S Alwashmi ◽

...

Keyword(s):

Saudi Arabia ◽

Hand Hygiene ◽

Healthcare Workers ◽

Primary Source ◽

Cross Sectional Study ◽

World Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Government ◽

Health Organization

Hand hygiene is among the most important factors of infection control in healthcare settings. Healthcare workers are considered the primary source of hospital acquired infection. We assessed the current state of hand hygiene knowledge, perception and practice among the healthcare workers in Qassim, Saudi Arabia. In this cross-sectional study we used the hand hygiene knowledge and perception questionnaire developed by the World Health Organization. Knowledge and perceptions were classified into good (80 – 100%), moderate (60 – 79%) and poor (<60% score). Majority of the healthcare workers had moderate knowledge (57.8%) and perception (73.4%) of hand hygiene. Males were less likely to have moderate/good knowledge compared to females (OR: 0.52, p<.05). Private healthcare workers were less likely (OR: 0.33, p<0.01) to have moderate/good perception compared to the government healthcare workers. Healthcare workers who received training on hand hygiene were 3.2 times likely (p<.05) to have good/moderate perception and 3.8 times likely (p<0.05) to routinely use alcohol-based hand-rub than the ones without such training. Physicians were 4.9 times likely (p<0.05) to routinely use alcohol-based hand-rub than the technicians. Our research highlighted gaps on hand hygiene knowledge and perception and practice among healthcare workers in Qassim and importance of training in this regard.

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Hand Hygiene Compliance Study at a Large Central Hospital in Vietnam

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16040607 ◽

2019 ◽

Vol 16 (4) ◽

pp. 607 ◽

Cited By ~ 6

Author(s):

Cam Le ◽

Erik Lehman ◽

Thanh Nguyen ◽

Timothy Craig

Keyword(s):

Quality Assurance ◽

Hand Hygiene ◽

Healthcare Workers ◽

Medical Center ◽

Compliance Rate ◽

World Health ◽

Limiting Factors ◽

Cultural Attitudes ◽

Knowledge And Attitude ◽

Hygiene Compliance

Lack of proper hand hygiene among healthcare workers has been identified as a core facilitator of hospital-acquired infections. Although the concept of hand hygiene quality assurance was introduced to Vietnam relatively recently, it has now become a national focus in an effort to improve the quality of care. Nonetheless, barriers such as resources, lack of education, and cultural norms may be limiting factors for this concept to be properly practiced. Our study aimed to assess the knowledge and attitude of healthcare workers toward hand hygiene and to identify barriers to compliance, as per the World Health Organization’s guidelines, through surveys at a large medical center in Vietnam. In addition, we aimed to evaluate the compliance rate across different hospital departments and the roles of healthcare workers through direct observation. Results showed that, in general, healthcare workers had good knowledge of hand hygiene guidelines, but not all believed in receiving reminders from patients. The barriers to compliance were identified as: limited resources, patient overcrowding, shortage of staff, allergic reactions to hand sanitizers, and lack of awareness. The overall compliance was 31%; physicians had the lowest rate of compliance at 15%, while nurses had the highest rate at 39%; internal medicine had the lowest rate at 16%, while the intensive care unit had the highest rate at 40%. In summary, it appears that addressing cultural attitudes in addition to enforcing repetitive quality assurance and assessment programs are needed to ensure adherence to safe hand washing.

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Association of Edentulism with Various Chronic Diseases in Mexican Elders 60+ Years: Results of a Population-Based Survey

Healthcare ◽

10.3390/healthcare9040404 ◽

2021 ◽

Vol 9 (4) ◽

pp. 404

Author(s):

Alejandro José Casanova-Rosado ◽

Juan Fernando Casanova-Rosado ◽

Mirna Minaya-Sánchez ◽

José Luís Robles-Minaya ◽

Juan Alejandro Casanova-Sarmiento ◽

...

Keyword(s):

Angina Pectoris ◽

Mental Disorders ◽

Chronic Diseases ◽

Population Based ◽

Self Report ◽

World Health ◽

Complex Nature ◽

Cluster Sampling ◽

World Health Survey ◽

Cross Sectional

Objective: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. Material and Methods: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). Results: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98); 56.2% were women. Chronic diseases’ prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p < 0.05) and depression in men aged 70 years and over (p < 0.0001) were associated with higher prevalence of edentulism. Conclusions: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.

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