- •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.
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Conflicts of interest: All authors report no conflicts of interest relevant to this article.
Financial Support: None to report.