Knowledge, Attitude and Practice of Hand Hygiene among Medical Students/ Practitioners – A Survey
Dr. S. Mithra1, Dr. Pratibha Ramani2, Dr. Herald J. Sherlin3, Dr. Gheena. S4, Dr. Abilasha Ramasubramaniam4, Dr. Gifrina Jayaraj4,
Dr. K. R. Don5, Dr. Archana Santhanam5
1I MDS, Post Graduate Student, Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, SIMATS, Chennai
2Professor and Head, Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, SIMATS, Chennai
3Professor, Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, SIMATS, Chennai
4Reader, Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, SIMATS, Chennai
5Senior Lecturer, Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, SIMATS, Chennai
*Corresponding Author E-mail: mithraswornappan@gmail.com
Abstract:
Background: Hand hygiene is considered one of the most important infection control method for preventing health care-associated infections. Though the techniques involved in hand hygiene are simple, the compliance with hand hygiene recommendations is poor worldwide. Objectives: The study was performed to assess the knowledge, attitudes, and practices (KAP) study on hand hygiene among medical. Materials and Methods: This cross-sectional study was conducted among 176 dental professionals and medical practitioners. Results: The response rate to the survey was 100%. About two third (72%) of the respondents exhibited good knowledge and 76.2% average knowledge about the risk factors. Overall 85% of the practitioners accepted due to time constrain it cannot be practised daily. Over 90.0% of the respondents were ready to undertake training course on Hand hygiene. CONCLUSION: This study proves the necessity of training sessions regarding hand hygiene practices among all medical professionals to provide a current knowledge in the area with a behavioural change in attitude and practice leading to reduction in the spread of nosocomial infections.
KEY WORDS: hand hygiene, infection, medical, dental.
1. INTRODUCTION:
Globally, thousands of people die every day due to infections acquired through health care procedures. Transmission of germs during health care primarily occurs through contaminated hands (1). Health care-associated pathogens can be received from infected or draining wounds, frequently colonized areas of the intact patients’ skin, patients’ gowns, bed linen, bedside furniture and other objects in the immediate environment of the patient. Organisms such as S. aureus, Proteus mirabilis, Klebsiella spp., Acinetobacter spp., enterococci, or Clostridium difficile may play an important role in health care associated infections (HCAIs) (2). Practicing hand hygiene (HH), either washing the hands with water and soap or using alcohol-based hand rub, is a simple effective way to prevent infections (3). Any medical practitioners, who is involved in patient care directly or indirectly, should be aware of HH importance and also be able to carry out HH properly (2). Although HH procedures are relatively simple, studies have shown that the compliance among healthcare workers is not favorable (4-8). Several barriers to compliance with HH have been explained include lack of education, lack of persuasion, high work load, working status and not being aware of implementation guidelines (9). Despite the high prevalence of HAIs in Asia, unfortunately there are few studies assessing this issue in this part of the world (10-12); therefore, it appears that there is still a growing need regarding this issue.
This cross-sectional analytic study was conducted for both dentists and medical practitioners in and around Chennai, Tamilnadu.
Inclusion criteria included practitioners who are practising a clinical setup, ability to read and write, and willingness to participate in the study. Exclusion criteria included incomplete questionnaire or individual reluctance for participation.
Based on the similar articles (13) about 30% of Iranian healthcare workers had good knowledge about hand hygiene. Considering 30% prevalence and the 2% of standard deviation, the sample size was determined to be 176.
According to the estimated sample size, 176 Medical and Dental practitioners were selected by simple random sampling method. Based on the list of the staff, personnel were asked to participate in the study. If they did not propend to fill the questionnaire, the next one was invited according to the list. Sampling continued until achieving the minimum sample size.
For collecting data in this study, “Hand Hygiene Knowledge Questionnaire” was used in google forms. The questionnaire contained questions on the participants’ age, gender, profession, year of the course, and a total of 17 multiple choice questions were given. Overall scores were expressed in percentage; so that an overall score of >75% was considered as good, 50–74% as moderate and <50% as poor knowledge.
Medical students and dental students were explained the content and nature of the study. Verbal consent was obtained from the participants.
3. RESULTS:
A total of 176 practitioners were invited to participate in this study. An overall of 87.4% of participants accepted that the chances of transmission of harmful infections through patients is possible. Around 87.7% of them accepted that following proper hand hygiene could prevent from bacterial transmission,81.5% of the chart showed that there is an effect in using hand rubs for a time limitation which can prevent from microorganism transmission.86.2% of the participants accepted that they follow correct protocol for HH. According to the analysis, 87.9% of the participants has complete knowledge in hand hygiene.
1. The main route of Transmission of potentially harmful germs are among patients in hospital?
174responses
3. Do you think hand hygiene protocol can prevent transmission of bacteria form patients to health care professionals?
173responses
4. Alcohol based hand rubs are more rapid for hand cleansing than hand washing
174 responses
7. Are there any time limitations for alcohol-based hand rubs to kill germs in hands
173 responses
8. Wearing jewellery Damaged skin, Artificial nails are associated with increased colonization of harmful bacteria in hands?
175 responses
13. Do you think wearing glove reduces the need for hand hygiene?
174 resoinses
11. In emergency cases it is difficult to follow hand hygiene at times?
174 responses
9. Is it necessary to receive formal training on hand hygiene?
174 responses
10. I do follow correct protocol for hand hygiene in my practice all time?
174 responses
12. Have you advised others to follow rules of hand hygiene?
172 responses
17. I have complete knowledge on hand hygiene?
174 responses
DISCUSSION:
In our study, all study groups had good knowledge of HH. Similar results were obtained in previous studies(13,14,16). The mean knowledge level in our study is higher compared to some similar studies in developed countries(17). In a study by Hosseini-alhashemi et al, training had no effect on knowledge level(14). Another study by Calabro et al is also showed that 75% of the participants had good knowledge(18). In a study by Duggan et al, a negative relationship was reported between professional education and the rate of hand washing compliance(19). Conversely, Suchitra et al reported that education had a positive impact on retention of knowledge, attitudes and practices in all health care worker categories(20). It seems that coupling educational programs that used cognitive, emotional and behavioral methods with motivational interventions is more effective(21,22). It seems that HH knowledge is considered more serious in nursing curriculums compared to medical students. Rezaee and her colleagues carried out an interventional study to assess the effect of an educational program on HH to medical students. The medical students who had passed physiopathology courses were selected to participate in a one-day teaching workshop about the importance of HH(23). This study highlights the importance of improving the current training programs targeting HH knowledge among medical students. According to our study the mean knowledge level was high for 95% medical professionals. Our results noted no difference in HH knowledge between men and women. The result is the same with some other studies that revealed that the overall score in knowledge did not differ between male and female nurses. Although some researchers noticed gender differences in the HH attitude and practice(24). A more detailed view showed that our participants have poor knowledge about the effect of hand rubbing and have an exaggerated belief about its side effect (skin dryness). The present study is a cross-sectional study and inherently has its own limitations. Our sample distribution was not uniform in the field of medical and dental. The main cause was the difference of the staff numbers and also cooperation of the staff. The strength of the study was assessing the knowledge level of different occupations in a hospital unit with different education levels and curriculums.
CONCLUSION:
This study highlighted the importance of hand hygiene in day to day practise. Emphasising hand hygiene training programs in medical students is one important issue that should be considered more seriously.
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Received on 19.10.2019 Modified on 31.10.2019 Accepted on 10.11.2019 ©A&V Publications All right reserved Research J. Science and Tech. 2019; 11(4):259-264. DOI: 10.5958/2349-2988.2019.00036.6 |
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