Evaluation of healthcare professionals' hand washing practices, attitudes, and knowledge

Abstract

Background: Nosocomial infections are primarily transmitted through the hands of healthcare workers (HCWs), making hand hygiene a critical component in preventing the spread of infectious agents. Despite guidelines from organizations such as the CDC, compliance with hand hygiene practices remains suboptimal, especially in developing countries where limited studies exist on the causes of non-compliance. Factors such as lack of awareness, negative attitudes, insufficient resources, and human-related challenges contribute to poor adherence to hand hygiene protocols.
Methods: This study, conducted over six months , aimed to evaluate the knowledge, attitudes, and practices of hand hygiene among HCWs . Data were collected via three tools: an observational form documenting hand hygiene opportunity, a ward inspection form assessing the availability of hand hygiene resources, and a self-administered questionnaire assessing HCWs' knowledge and attitudes. A total of 2,500 hand hygiene opportunities were observed across multiple hospital departments, and 200 HCWs completed the questionnaire. The study focused on procedures such as invasive and non-invasive interventions, personal contact, body fluids handling, and waste disposal.
Results: The study found that nurses performed the majority of observed hand hygiene opportunities . Compliance was higher among doctors (37.5%) compared to other HCWs, but only 11.6% of doctors' hand hygiene opportunities were performed correctly. Routine hand washing was the most common practice (64.2%), while antiseptic hand washing was rare (3.9%). Knowledge scores for nurses (42.6 ± 11.7) were higher than for doctors (39.1 ± 10.5), with the NICU pediatric department having the highest knowledge scores. Nurses had a generally positive attitude towards hand hygiene, with 96% acknowledging its protective role, though only 70.7% believed role modeling could improve practices. The most frequent error in hand hygiene was improper drying and insufficient contact time. Ward inspections revealed that most wards had sinks (80%) but lacked essential resources like paper towels for drying hands (0%).
Conclusion: Hand hygiene practices among HCWs are suboptimal, despite good knowledge and positive attitudes towards hand hygiene. Key issues include improper technique and insufficient resources. To improve compliance, interventions should address both cognitive and resource-related challenges, and strengthen monitoring and role modeling within healthcare settings.