Observed and Self-reported Hand Hygiene Compliances and Associated Factors among Healthcare Workers at a County Referral Hospital in Kenya

Abstract

Background: Hand hygiene is effective in preventing and controlling healthcare-associated infections (HCAIs); however, its compliance remains low, and reasons are poorly understood, thus its research and feedback may lead to successful interventions. This study aimed to explore the observed and self-reported hand hygiene compliance and associated factors among healthcare workers (HCWs) in the medical/surgical ward of a county referral hospital. Methods: Cross-sectional study design was used in this study. Direct observation guided by 5 moments for hand hygiene concept was carried to describe compliance, and the questionnaire technique informed by Theoretical Domains Framework (TDF) was employed to investigate self-reported compliance, barriers, and facilitators of hand hygiene compliance. This study was done at a county referral hospital in Kenya. The total number of hand hygiene opportunities observed was 347 among 55 HCWs, and 132 HCWs filled the questionnaires. Results: The overall compliance based on direct observation was 23.9%, whereas self-reported compliance was 80.0%. Hand hygiene was significantly associated with indication (p < 0.001), training (p = 0.014), social influences (p = 0.002) and knowledge (p = 0.044). Barriers identified were environmental resources, social influences, beliefs about consequences, memory, attention, and decision processes. Facilitators included knowledge and social/professional role, and identity.Conclusions: Despite the high report rate of hand hygiene compliance, the observed compliance is unacceptably low. Although knowledge, and social/professional role and identity of the HCWs may primarily facilitate hand hygiene compliance, barriers associated with non-compliance such as environmental resources remain significant constraints and should be considered to ensure optimal hand hygiene compliance and quality of patient care. The results also suggest that HCWs education on hand hygiene still needs improvements, particularly on the 5 moments for hand hygiene.

Relationship Between Self-Reported Hand Hygiene Beliefs and Hand Hygiene Practices in Nursing Students: A Structural Equation Modeling

“…In the literature; some studies are stating that beliefs are a significant predictor in putting knowledge into practice [15], that there is a low level of relationship between beliefs and practice [19], and that there is no significant relationship between beliefs and practice [20]. It is believed that defining the hand hygiene beliefs of nursing students may affect their hand hygiene knowledge and practices and may help develop a positive point of view towards hand hygiene practice culture.…”

Hand Hygiene Practices among Healthcare Professionals based on Theory of Planned Behaviour during Corona Pandemic in Pakistan.

“…Serious disease-causing pathogens are found in healthcare setting that includes Streptococcus pyogenes, Streptococcus pneumoniae, Staphylococcus epidermidis, and Community-Associated Methicillin-Resistant Staphylococcus. 1 Hand washing practices are inexpensive and effective to prevent health detrimental diseases. Improving hand hy-giene among healthcare professionals has become essential to minimize communicable diseases.…”