Hand hygiene knowledge, perception, and self-reported practice among healthcare workers in a tertiary care hospital: a cross-sectional study

Abstract

Hand hygiene (HH) regimens significantly prevent the spread of healthcare-associated infections and multidrug-resistant organisms. Practising correct HH is crucial in achieving the target of near-zero infections. Globally, HH compliance rates among healthcare workers (HCWs) remain suboptimal. This study aimed to evaluate HCWs’ hand hygiene knowledge, perception and self-reported practice and their correlations in a tertiary care hospital in Qatar. A cross-sectional study was conducted at Al Ahli Hospital, an Australian Council on Healthcare Standards International (ACHSI) accredited tertiary care hospital, from December 2023 to February 2024. The final analytical sample comprised 434 licensed HCWs (physicians, nurses and allied health professionals) responses. A validated self-administered questionnaire from the World Health Organisation and the Centers for Disease Control resource was used. Descriptive and inferential statistics were used for analysis. The mean and standard deviation scores of knowledge, perception, and self-reported practice were 24.9 ± 2.83, 25.5 ± 2.69, and 18 ± 2.99 respectively. 65% of HCWs demonstrated a high level of knowledge. Between 57% and 90% of HCWs perceived HH as highly important, whereas 59 to 86% of HCWs self-reported that they performed HH more than 95% of the time in a day. Pearson’s correlation analysis showed significant positive correlations between HH knowledge and self-reported practice (r = 0.215, P < 0.001). Chi-square test and one-way ANOVA analysis shown statistically significant differences (p < 0.05) across professional groups for selected knowledge, perception and self-reported practice items. These findings revealed that nurses were moderately compliant, which potentially reflects patient contact and nature. Post-hoc Bonferroni analyses showed statistically significant mean group differences (p < 0.05) confirming that nurses performed better than physicians and allied health professionals. Major barriers to HH practice included being too busy, lacking time, skin irritation and prioritisation of patient needs. HCWs possess strong knowledge and positive perception toward HH, and notable gaps persist between their understanding and their self-reported practices. These findings highlight the need for periodical monitoring and specialised HH modular training integrated with behavioural interventions. A collaborative approach involving all stakeholders is essential to implement strategic initiatives to eliminate the identified barriers and improve HH compliance, contributing to improved patient safety.