Knowledge, attitude and practice of hand hygiene among health care assistants and patient's family members at a tertiary hospital in Guangzhou, southern China : a cross-sectional study

Abstract

Aim: To explore the extent of adherence to hand hygiene as a means for infection control by in-patients’ caregivers, and to identify factors in relation to caregivers’ adherence of hand hygiene practice guidelines.

Background: Low compliance rate of hand hygiene among inpatients’ caregivers may lead to cross infection in hospitals and may be associated with detectable changes in the incidence of healthcare-associated infections. While hand hygiene education regarding infection control is given to each health care worker working in hospital settings, health care assistants and patients’ family members who often provide care to in-hospital patients have not received or undergone compulsory hand hygiene training. Little is known about the inpatients’ caregivers’ attitude towards hand hygiene and their hand hygiene practices in mainland China. Such information is particular important since non-hospital health care assistants (HCAs) and patient’s family members (PFMs) are common caregivers for in-patients in mainland China. Such information can guide policymakers to formulate specific health polices to prevent healthcare-associated infections.

Methods: This cross sectional study was conducted from February 2015 to March 2015 in a tertiary public hospital in Guangzhou, southern China. Survey data were collected using the pretested questionnaire developed by Centers for Disease Control of Taiwan on 232 health care assistants and patient’s family members selected in the Department of Internal Medicine, Department of Surgery and Department of Geriatrics in this hospital. Descriptive statistics were used to analyze the frequency, mean, standard deviation and other statistics. Multivariate linear regression analysis was used to examine the relationship between hand hygiene knowledge and hand hygiene practice when caring in-patients, adjusted for the effect of demographic variables. The level of statistically significant was set at 0.05.

Results: Nearly half of health care assistants and patient’s family members had good knowledge of hand hygiene (mean scores= 69.11+8.25). Over 90% participants had positive attitudes towards hand hygiene and current health education tools regarding hand hygiene. Only 41.4% of participants had good hand hygiene practice (mean scores=24.47+4.36). Results of multivariate linear regression analysis showed that female gender (β=1.511, P=0.034) and knowledge level towards hand hygiene (β=0.07, P =0.001) had positive correlation with hand hygiene practice. Obstacles to hand hygiene mainly included misperception of gloves use, lack of time, and poor hand hygiene knowledge. Increasing hand washing facilities was considered as the most effective intervention to improve their adherence.

Conclusion: Although the majority of patient’s caregivers had a positive attitude towards hand hygiene, lack of knowledge regarding ‘Five Moments for Hand Hygiene’ and low hand hygiene adherence still persisted among health care assistants and patient’s family members. Future study should explore strategies to improve HCAs and PFMs knowledge and practice about hand hygiene. Health education and surveillance regarding hand hygiene should be conducted among patient’s caregivers.