Cross-Sectional Survey of Hand-Hygiene Compliance and Attitudes of Health Care Workers and Visitors in the Intensive Care Units at King Chulalongkorn Memorial Hospital
Kanitha Patarakul, MD, PhD* Auchana Tan-Khum RN, MSc**, Suthada Kanha RN**, MNS, Darunee Padungpean RN, MNS**, Ong-Orn Jaichaiyapum RN, BSN**
Affiliation : * Department of Microbiology, Faculty of Medicine, Chulalongkorn University ** Department of Nursing, King Chulalongkorn Memorial Hospital
Background : Hand hygiene is the most important and effective measure to prevent cross-infection in hospi-
tals. Hand-hygiene campaign must be implemented as a part of infection control program at King Chulalongkorn
Memorial Hospital (KCMH). The behavior, attitudes, and beliefs of health care workers (HCWs) and visitors
regarding hand-hygiene practices have never been studied in KCMH.
Objectives : To determine the baseline compliance and assess the attitudes and beliefs regarding hand hygiene
of HCWs and visitors in intensive care units (ICUs) at KCMH.
Materials and Methods : We observed hand-hygiene compliance of HCWs and visitors in ICUs before patient
contact for eight hours. A self-administered questionnaire was employed to measure attitudes and beliefs
about hand hygiene for two-week period.
Results : Overall hand-hygiene compliance obtained from this observational study was less than 50% and
differed markedly among various professional categories of HCWs and visitors. In questionnaire-based study,
patient needs perceived as a priority (51.2%) was the most common reason for non-compliance, followed by
forgetfulness (35.7%), and skin irritation by hand-hygiene agents (15.5%). Subjects believed to improve their
compliance by multiple strategies including available low irritating hand-hygiene agents (53.4%), informa-
tion of current nosocomial infection rate (49.1%), and easily accessed hand-hygiene supplies (46.3%). Al-
most all subjects (99.7%) claimed to know correct hand-hygiene techniques. Handwashing with medicated
soap was perceived to be the best mean of hand decontamination (37.8%).
Conclusion : Hand-hygiene compliance of HCWs and visitors is unacceptably low. Their knowledge, behav-
ior, attitudes, and beliefs toward hand hygiene need to be improved by the multimodal and multidisciplinary
approach.
Keywords : Hand hygiene, Handwashing, Compliance, Attitudes, Nosocomial infection
