The knowledge of hand hygiene among the healthcare workers of two teaching hospitals in Mashhad
Keywords:
Hand hygiene, Cross infection, Health personnel, KnowledgeAbstract
Introduction: Healthcare-associated infections (HAIs) affect millions of patients worldwide annually. Hand hygiene (HH) has been identified as the single most important factor preventing HAIs. The aim of this study was to determine the knowledge regarding hand hygiene practices amongst health care workers, and identifying the areas of gaps in their knowledge.
Methods: This cross-sectional analytic study was conducted in two university hospitals in Mashhad, Iran between May 2014 and September 2015. Data was collected using a translated version of the World Health Organization (WHO) Hand Hygiene Knowledge Questionnaire (revised 2009). The questionnaire contained questions on the participants’ age, gender, profession, year of the course, formal training in HH and 27 multiple choice and "yes” or “no” questions to assess HH knowledge. Data were entered into IBM SPSS Statistics, Version 16. Descriptive statistical methods and also analytical statistical methods include ANOVA and Independent-samples t-test were used in data analyzing.
Results: In total, 161 respondents including 32 residents, 92 nurses and 37 nursing assistants enrolled in this study. All study groups had a moderate knowledge of HH. The score of 21% was ≤ 50% (poor) and only 10.6% had a good knowledge score (i.e. the score ≥75%). There was no significant difference in the knowledge level of the participants who had received formal training in HH and those who had not (p=0.68). Also, the mean knowledge score was not associated with age (p=0.12), gender (p=0.84), department (p=0.96) or profession (p=0.43).
Conclusion: This study highlights the importance of applying the multimodal training program addressing providers' knowledge regarding hand hygiene, as well as strategies for cognitive, emotional and behavioral methods such as patient engagement in hand-hygiene interventions.
References
Trampuz A, Widmer AF. Hand Hygiene: A frequently missed lifesaving opportunity during patient care.
Mayo Clin Proc. 2004; 79:109-16. doi: 10.4065/79.1.109. PMID: 14708954.
Guideline for Hand Hygiene in Health-Care Settings. 2002.
Guidelines on Prevention and Control of Hospital Associated Infections. 2002. Available from:
Thakker VS, Jadhav PR. Knowledge of hand hygiene in undergraduate medical, dental, and nursing
students: A cross-sectional survey. J Family Med Prim Care. 2015; 4(4): 582–6. doi: 10.4103/2249- 4863.174298. PMID: 26985420, PMCID: PMC4776613.
Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, et al. Effectiveness of a hospital- wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet. 2000;
(9238): 1307–12. doi: 10.1016/S0140-6736(00)02814-2. PMID: 11073019.
Longtin Y, Sax H, Allegranzi B, Schneider F, Pittet D. Videos in clinical medicine hand hygiene. N Engl J
Med. 2011; 364:e24. doi: 10.1056/NEJMvcm0903599.
Tibballs J. Teaching hospital medical staff to handwash. Med J Aust. 1996; 164: 395–8. PMID: 8609848.
Trampuz A, Widmer AF. Hand hygiene: A frequently missed lifesaving opportunity during patient care.
Mayo Clin Proc. 2004; 79: 109-16. doi: 10.4065/79.1.10 . PMID: 14708954.
Boyce JM, Pittet D. Healthcare Infection Control Practices Advisory Committee;
HICPAC/SHEA/APIC/IDSA HH Task Force. Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the
HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of
America/Association for Professionals in Infection Control/Infectious Diseases Society of America.
MMWR Recomm Rep. 2002; 51(RR-16): 1–45. PMID: 12418624.
Anwar MA, Rabbi S, Masroor M, Majeed F, Andrades M, Baqi S. Self-reported practices of hand hygiene
among the trainees of a teaching hospital in a resource limited country. J Pak Med Assoc. 2009; 59(9): 631- 34. PMID: 19750862.
Patarakul K, Tan-Khum A, Kanha S, Padungpean D, Jaichaiyapum O. Cross-sectional survey of hand- hygiene compliance and attitudes of health care workers and visitors in the intensive care units at King
Chulalongkorn Memorial Hospital. J Med Assoc Thai. 2005; 88(Suppl 4): 287-93. PMID: 16623043.
Nair S, Hanumantappa R, Hiremath GS, Asaduddin Siraj M, Raghunath P. Knowledge, Attitude, and
Practice of Hand Hygiene among Medical and Nursing Students at a Tertiary Health Care Centre in
Raichur, India. ISRN Prev Med. 2014; 2014: 608927. doi: 10.1155/2014/608927. PMID: 24967144,
PMCID: PMC4045463.
Maheshwari V, Kaore NC, Ramnani VK, Gupta SK, Borle A, Kaushal R. A Study to Assess Knowledge
and Attitude Regarding Hand Hygiene amongst Residents and Nursing Staff in a Tertiary Health Care
Setting of Bhopal City. J Clin Diagn Res. 2014; 8(8): DC04-7. doi: 10.7860/JCDR/2014/8510.4696. PMID:
, PMCID: PMC4190714.
Hosseini alhashemi M, Sadeghipour Kermani F, Palenik CJ, Pourasghari H, Askarian M. Knowledge,
attitudes, and practices of health care personnel concerning hand hygiene in Shiraz University of Medical
Sciences hospitals, 2013-2014. Am J Infect Control. 2015; 43 (9): 1009-11. doi:
1016/j.ajic.2015.05.002. PMID: 26116331.
Ghadamgahi F, Zighaimat F, Ebadi A, Houshmand A. Knowledge, attitude and self-efficacy of nursing
staffs in hospital infections control. Iranian Journal of Military Medicine. 2011; 13(3): 167-72.
Askarian M, Memish ZA, Khan AA. Knowledge, practice, and attitude among Iranian nurses, midwives,
and students regarding standard isolation precautions. Infect Control Hosp Epidemiol. 2007; 28(2): 241-4.
doi: 10.1086/510868. PMID: 17265414.
Van De Mortel TF, Kermode S, Progano T, Sansoni J. A comparison of the hand hygiene knowledge,
beliefs and practices of Italian nursing and medical students. J Adv Nurs. 2012; 68(3): 569-79. doi:
1111/j.1365-2648.2011.05758.x. PMID: 21722171.
Calabro K, Bright K, Kouzekanani K. Long-term Effectiveness of Infection Control Training among
Fourth-year Medical Students. Med Educ Online. 2005: 1-7
Duggan JM, Hensley S, Khuder S, Papadimos TJ, Jacobs L. Inverse correlation between level of
professional education and rate of handwashing compliance in a teaching hospital. Infect Control Hosp
Epidemiol. 2008; 29(6): 534-8. doi: 10.1086/588164. PMID: 18476776.
Suchitra JB, Lakshmi Devi N. Impact of education on knowledge, attitudes and practices among various
categories of health care workers on nosocomial infections. Indian J Med Microbiol. 2007; 25(3): 181-7.
doi: 10.4103/0255-0857.34757. PMID: 17901633.
Salamati P, Poursharifi H, Rahbarimanesh AA, Koochak HE, Najafi Z. Effectiveness of motivational
interviewing in promoting hand hygiene of nursing personnel. Int J Prev Med. 2013; 4(4): 441-7. PMID:
, PMCID: PMC3650597.
Pfoh E, Dy S, Engineer C. Interventions To Improve Hand Hygiene Compliance: Brief Update Review. In:
Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices. 2013. Available from: https://www.ncbi.nlm.nih.gov/books/NBK133371/.
Van de Mortel TF, Apostolopoulou E, Petrikkos G. A comparison of the hand hygiene knowledge, beliefs,
and practices of Greek nursing and medical students. Am J Infect Control. 2010; 38(1): 75-7. PMID:
doi: 10.1016/j.ajic.2009.05.006.
Rezaee R, Danaei M, Askarian M. The Efficacy of Teaching hand Hygiene to Medical students: An
Interventional Study. International Journal of Academic Research in Business and Social Sciences. 2014;
(4): 151-9. doi: 10.6007/IJARBSS/v4-i9/1138.
Kim EK, Joo MK, Baik SY, Hong SK. P161: Knowledge and perception toward hand hygiene among
health-care workers in teaching hospital, Korea. Antimicrob Resist Infect Control. 2013; 2(Supp1): 161.
doi: 10.1186/2047-2994-2-S1-P161.
Van De Mortel T, Bourke R, McLoughlin J, Nonu M, Reis M. Gender influences handwashing rates in the
critical care unit. Am J Infect Control. 2001; 29: 395-9. doi: 10.1067/mic.2001.119511. PMID: 11743487.
Cruz JP, Cruz CP, Al-Otaibi AS. Gender differences in hand hygiene among Saudi nursing students.
International Journal of Infection Control. 2015; 11(4). doi: 10.3396/IJIC.v11i4.029.15.
Cruz JP, Bashtawi MA. Predictors of hand hygiene practice among Saudi nursing students: A cross- sectional self-reported study. J Infect Public Health. 2016; 9(4): 485-93. doi: 10.1016/j.jiph.2015.11.010.
PMID: 26707706.
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