Adherence to basic hygiene routines in an infectious disease setting: associations with knowledge and professional role

Abstract

Introduction Healthcare-associated infections (HAIs) are a major global health concern, leading to increased morbidity, mortality, healthcare costs, and prolonged hospital stays. Adherence to basic hygiene routines is a key preventive measure, yet adherence varies among healthcare professionals. Objective To examine adherence to basic hygiene routines among healthcare professionals in an infectious disease clinic and to explore how knowledge, profession, and work-environment factors influence adherence. Methods A cross-sectional study using a quantitative observational and questionnaire-based design was conducted at an infectious disease clinic in Sweden. A total of 69 healthcare professionals (assistant nurses, registered nurses, and physicians) were recruited through convenience sampling. Data were collected over a four-week period through structured observations, a knowledge test, and a self-assessment questionnaire. The observations were conducted during day and evening shifts using a structured observation protocol. Statistical analyses included descriptive statistics, ANOVA, non-parametric tests, and correlation analyses. Results The overall observed adherence to basic hygiene routines was 76.4% (±20.2). Registered nurses demonstrated significantly higher adherence than physicians. Self-assessed adherence was higher (92.1% ± 3.3), indicating a discrepancy between perceived and observed behavior. Knowledge levels were generally high (median 90.9%, IQR 81.8–97.7), with registered nurses scoring significantly higher than other professions. No significant correlation was found between knowledge and observed adherence. Perceptions of the impact of the work environment factors on hand hygiene varied, with substantial proportions reporting both agreement and disagreement. Conclusion Although healthcare professionals demonstrated good knowledge and generally positive self-assessed adherence, observed adherence to hygiene routines was suboptimal and varied between professions. The lack of correlation between knowledge and adherence suggests that factors beyond knowledge, such as organizational culture and behavioral aspects, are critical. Targeted interventions focusing on behavioral change, feedback, and interprofessional collaboration are needed to improve adherence and reduce HAIs.