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Hand hygiene knowledge, attitudes, and practices among hospital inpatients: A descriptive study

  • Jocelyn A. Srigley
    Correspondence
    Address correspondence to Jocelyn A. Srigley, MD, MSc, Department of Pathology and Laboratory medicine, BC Children's Hospital, 4500 Oak St, Rm 2J3, Vancouver, British Colombia, Canada V6H 3N1.
    Affiliations
    Department of Medicine, McMaster University, Hamilton, Ontario, Canada

    Hamilton Health Sciences, Hamilton, Ontario, Canada

    Department of Pathology and Laboratory Medicine, BC Children's and Women's Hospitals, Vancouver, British Columbia, Canada

    Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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  • Sung Min Cho
    Affiliations
    Department of Medicine, McMaster University, Hamilton, Ontario, Canada

    Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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  • Cindy O'Neill
    Affiliations
    Hamilton Health Sciences, Hamilton, Ontario, Canada
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  • Anne Bialachowski
    Affiliations
    St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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  • R. Ayesha Ali
    Affiliations
    Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, Canada
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  • Christine Lee
    Affiliations
    Department of Medicine, McMaster University, Hamilton, Ontario, Canada

    Hamilton Health Sciences, Hamilton, Ontario, Canada

    St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada

    Island Health Authority, Victoria, British Columbia, Canada

    Department of Pathology and Laboratory Medicine, McMaster University, Hamilton, Ontario, Canada
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  • Dominik Mertz
    Affiliations
    Department of Medicine, McMaster University, Hamilton, Ontario, Canada

    Hamilton Health Sciences, Hamilton, Ontario, Canada

    Department of Pathology and Laboratory Medicine, McMaster University, Hamilton, Ontario, Canada

    Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Published:December 27, 2019DOI:https://doi.org/10.1016/j.ajic.2019.11.020

      Highlights

      • Self-reported patient hand hygiene rates are suboptimal.
      • There are knowledge gaps among patients as to when to perform hand hygiene.
      • Patients are not receptive to receiving traditional educational interventions.
      • Intervention foci may include bedside hand sanitizer, reminders, or role modeling.

      Background

      Pathogens may be transmitted in hospitals via patients’ own hands, but little is known about the facilitators and barriers of hand hygiene among inpatients. This study aimed to assess the hand hygiene knowledge, attitudes, and practices of adult inpatients at 5 hospitals.

      Methods

      The study consisted of a cross-sectional survey distributed followed by structured interviews with randomly selected inpatients. Qualitative data were analyzed independently by 2 researchers using the Theoretical Domains Framework.

      Results

      A total of 268 surveys were completed, with 66.4% of patients reporting always performing hand hygiene after toileting and 49.2% before eating. The majority of patients (74.6%) stated that they did not want to receive more information about hand hygiene while in the hospital. Key themes identified from 23 interviews include knowledge; environmental context and resources; memory, attention, and decision processes; and social influences.

      Conclusions

      Self-reported patient hand hygiene rates are suboptimal and there are knowledge gaps among patients as to when to perform hand hygiene, but patients are not receptive to receiving traditional educational interventions. Future interventions to improve patient hand hygiene should focus on other behavior change domains, including environmental context and resources (eg, access to hand sanitizer at the bedside), memory, attention, and decision processes (eg, posters or other reminders), and social influences (eg, role modeling).

      Key Words

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