E-ISSN:2456-1487
P-ISSN:2456-9887
RNI:MPENG/2017/70771

Research Article

Hand Hygiene

Tropical Journal of Pathology and Microbiology

2021 Volume 7 Number 5 September October
Publisherwww.medresearch.in

Knowledge, Attitude, and Practice of Hand Hygiene among Medical students and Nurses at a Tertiary Health Care Centre in Ratlam, Madhya Pradesh

Songara P.1, Saxena G.2*
DOI: https://doi.org/10.17511/jopm.2021.i05.06

1 Prafulla Songara, Associate Professor, Department of Microbiology, GMC, Ratlam, MP, India.

2* Gaurav Saxena, Assistant Professor, Department of Microbiology , GMC, Ratlam, MP, India.

Background: Hand hygiene is considered the leading measure to prevent cross-transmission of microorganisms. Regarding hospital-acquired infections, compliance with handwashing guidelines seems vital in preventing disease transmission among patients. The objective of this study was to assess the level of knowledge, attitude and practice in various aspects of hand hygiene in medical students and nurses for identifying gaps in hospital infection control adherence and planning for necessary corrective measures. Methods: A cross-sectional study was conducted among 70 medical students and 50 nurses in a tertiary medical college in India. Knowledge was assessed using the WHO hand hygiene questionnaire. Attitude and practices were evaluated by using another self-structured questionnaire. Results: Both the study groups exhibited moderate levels of knowledge regarding hand hygiene. Nurses were found to exhibit a higher level of attitude and practice than medical students.

Keywords: Hand hygiene, Medical students, Nurses

Corresponding Author How to Cite this Article To Browse
Gaurav Saxena, Assistant Professor, Department of Microbiology , GMC, Ratlam, MP, India.
Email: 		Prafulla Songara, Gaurav Saxena, Knowledge, Attitude, and Practice of Hand Hygiene among Medical students and Nurses at a Tertiary Health Care Centre in Ratlam, Madhya Pradesh. Trop J Pathol Microbiol. 2021;7(5):248-253.
Available From
https://pathology.medresearch.in/index.php/jopm/article/view/569

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2021-08-07 2021-08-10 2021-08-17 2021-08-24 2021-08-31
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 17%

© 2021by Prafulla Songara, Gaurav Saxenaand Published by Siddharth Health Research and Social Welfare Society. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

Tropical Journal of Pathology and Microbiology 2021;7(5)248
Songra P. et al: Knowledge, Attitude, and Practice of Hand Hygiene

Introduction

Hand hygiene is considered the leading measure to prevent cross-transmission of microorganisms. It is one of the critical initiatives put forth by the World Alliance for Global Patient Safety Challenges. Hand hygiene is a simple action, but the lack of compliance among healthcare providers is problematic worldwide [1]. Although Semmelweis demonstrated more than a century ago that only hand washing was sufficient in reducing the incidence of HAIs, the compliance toward handwashing practices remains low [2-4]. Compliance with handwashing guidelines seems vital in preventing disease transmission among patients [5-7]. There is an urgent need for planning & formulation of policies for the implementation of basic infection prevention practices in healthcare setups.

Aim and objective

The aim & objective of this study was to assess the level of knowledge, attitude and practice in various aspects of hand hygiene in medical students and nurses for identifying gaps in hospital infection control adherence and planning for necessary corrective measures.

Material and Method

This cross-sectional study was conducted at Government Medical College Ratlam, India. It is a tertiary care centre located in the tribal belt of western Madhya Pradesh. Study participants were explained the content, nature, aim and objectives of the study. Informed verbal consent was taken from 70 medical students and 50 nurses who volunteered to participate. A self-administered questionnaire containing a set of questions regarding hand-hygiene knowledge, attitudes, and practices was distributed to all participants.

Knowledge was assessed using WHO's hand hygiene questionnaire for health care workers. A total of 25 multiple choice and dichotomous type questions were provided to the participants.

Attitude and hand hygiene practices were assessed using another self-structured questionnaire which consists of 10 & 8 questions, respectively.

Descriptive statistics were used to calculate percentages for each of the responses given.

Result

A total of 120 partici­pants (70 medical students and 50 nurses) were enrolled in the study. The nursing group includes trained nurses posted at various departments, and the medical student's group have 2nd-year MBBS students.

Knowledge on hand hygiene: The overall knowledge of hand hygiene among the par­ticipants was moderate (medical students 63.83 %, nursing 64.56%). The percentages of correct responses of the two groups of the individual questions on hand hygiene knowledge are given in table 1.

Attitude to hand hygiene: The participants' response to attitude-based questions revealed that their attitude towards hand hygiene was not sat­isfactory. But nurses showed a positive attitude towards hand hygiene compared to the medical students (Table 2). The response of the participants to attitude-based questions is given in table 3.

The practice of hand hygiene: On analysis of the hand hygiene practice among the partic­ipants, most of them exhibited poor hand hygiene practice (medical students-73%, nursing - 57%), and only a few showed good hand hygiene practice (medical -3%, nursing -5%). On com­paring, nurses showed better hand hygiene practice than medical students.

Table 1: Knowledge regarding Hand Hygiene. Refer Page No 252

Table 2: Attitude towards hand washing. Refer Page No 253

Table 3: Practices of health workers. Refer Page No 253

Discussion

Hand hygiene is one of the most important tools in preventing the transmission of Hospital associated infections as the hands of HCWs are the most common mode of transmission of pathogens to patients. As per different studies across the world, factors that contribute to poor adherence to hand hygiene include lack of knowledge among HCWs, poor access


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to handwashing facilities (sinks), the time required to perform standard hand wash­ing, irritant contact dermatitis associated with frequent expo­sure to soap and water, high workloads and the administrative apathy towards prioritizing hand hygiene practices at the institutional level. [8-10].

Our study found out that medical students & nurses had moderate knowledge of hand hygiene. Although this was encouraging, in our view this knowledge gap can be addressed by arranging more regular and frequent training sessions. The attitude of the participants towards hand hygiene was overall poor. Nearly 85.71% of the medical students & 54 % of nurses agreed that they don't adhere to correct hand hygiene practice despite good knowledge of these groups on hand hygiene. The participants decided to various reasons for not adhering to hand hygiene like other works, forgetfulness and emergencies. Such poor attitude was seen more among the medical students than nurses. Nearly 28.57% of medical students and 24% of the nurses had the misconception that wearing gloves obviates the need for practising hand hygiene. 47.14% of medical students & 54 % of nurses in our study felt that following hand hygiene was difficult in the current setup. Nearly 47.14% of the medical students and 38% of the nurses were not satisfied with facilities for hand hygiene. This could be due to the lack of adequate facilities at some places and could be overcome by keeping bedside hand rubs, maintaining the patient to sink ratio & buffering stock of the consumables. The participants also felt that the presence of infection control notice boards in the workplace would positively influence adherence to hand hygiene.

Conclusion

Hand hygiene is one of the simplest and effective practices to prevent infections; knowledge and compliance are still poor. The present study highlights the need for periodical training sessions regarding hand hygiene practices among the health care workers to provide the current knowledge in the area with a behavioural change in attitudes and practices leading to reduction of nosocomial infections.

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