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Patient, family, and visitor hand hygiene knowledge, attitudes, and practices at pediatric and maternity hospitals: A descriptive study

Published:March 01, 2021DOI:https://doi.org/10.1016/j.ajic.2021.02.015

      Highlights

      • A survey and direct observation of patients, families, and visitors at a pediatric and maternity hospital were used to assess hand hygiene knowledge, attitudes, and practices.
      • There was a clear preference for hand washing with soap and water over use of alcohol-based hand rub, both in survey responses and in observed hand hygiene behavior.
      • Self-reported hand hygiene rates were higher than observed rates, with an overall observed hand hygiene rate of 10.3%.
      • Beliefs about consequences were the main driver for hand hygiene.
      • Development of interventions to improve hand hygiene should focus on correcting misconceptions and emphasizing consequences of failing to perform hand hygiene in the health care setting.

      Abstract

      Background

      Patient, family, and visitor hand hygiene can prevent health care-associated infections, but little is known about their hand hygiene knowledge, attitudes, and practices. We aimed to assess patient, family, and visitor hand hygiene knowledge, attitudes, and practices at a pediatric and maternity hospital in Vancouver, British Columbia, Canada.

      Methods

      Surveys based on the Theoretical Domains Framework were distributed to patients, families, and visitors to provide cross-sectional qualitative and quantitative data. This was supplemented with covert observations by trained medical students to determine patient, family, and visitor hand hygiene rates.

      Results

      Of 348 survey respondents, there was a clear preference for hand washing with soap and water over use of alcohol-based hand rub. Beliefs about consequences were the main driver for hand hygiene. Self-reported hand hygiene rates were higher than observed rates. The overall hand hygiene rate was observed to be 10.3% (72/701), with soap and water used for 75% of hand hygiene events.

      Conclusion

      There are misconceptions regarding hand hygiene practices and low hand hygiene rates among patients, families, and visitors. Development of interventions to improve hand hygiene should focus on correcting misconceptions and emphasizing consequences of failing to perform hand hygiene in the health care setting.

      Key Words

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