Importance of structured training programs and good role models in hand hygiene in developing countries

Area of Science:

• Infection Control
• Healthcare Worker Education
• Health Behavior Theory

Background:

• Hand hygiene is critical for preventing healthcare-associated infections (HAIs).
• Understanding healthcare workers' (HCWs) beliefs is essential for effective infection control programs, especially in resource-limited settings.
• Existing research often focuses on developed countries; less is known about perceptions in institutions with newly established infection control programs.

Purpose of the Study:

• To identify beliefs and perceptions influencing hand hygiene performance among HCWs in two resource-limited hospitals.
• To compare these beliefs between a university hospital and a community hospital with similar infection control promotion campaigns.
• To inform strategies for improving hand hygiene compliance in developing countries.

Main Methods:

• A self-administered questionnaire, based on The Theory of Planned Behavior, was distributed to nurses, nurse students, physicians, and medical students.
• The study was conducted in two hospitals (University Hospital and Community Hospital) within the same city.
• Data were collected on demographic information, behavioral, normative, and control beliefs related to hand hygiene.

Main Results:

• All professional categories believed hand hygiene effectively prevents infections (98%).
• Nurses in the Community Hospital perceived the frequency, severity, and impact of HAIs as lower than those in the University Hospital.
• Multivariate analysis showed that structured training, perceived colleague adherence, ease of performance, and being observed were independently associated with high self-reported hand hygiene adherence.

Conclusions:

• Significant differences in beliefs regarding HAIs exist between nurses in different types of institutions, despite similar promotion campaigns.
• Intention to comply with hand hygiene in resource-limited settings is associated with training and strong normative/control beliefs.
• Increased resource allocation for HCW training and ensuring easy access to hand hygiene products are recommended for developing countries.