Healthcare workers' hand hygiene knowledge and compliance evaluation, in a Greek university hospital

Healthcare associated infections affect both patients and employees, in terms of morbidity, mortality, and financial costs. Routine hand hygiene is the most important factor against this pestilence. Hand hygiene knowledge and compliance of healthcare workers are considered poor worldwide. Herein, we aimed to measure knowledge and compliance with hand hygiene of the healthcare workers at a university hospital.

The "WHO hand hygiene knowledge questionnaire for healthcare workers" was translated in the Greek language, and was validated linguistically, culturally, and psychometrically. Reliability, content, construct, and convergent validity were measured. A survey on hand hygiene knowledge, and compliance, based on this questionnaire, was conducted on 439 employees.

The translated questionnaire presented good reliability, with Guttman's Lambda-6 evaluation (0.7). Content Validity Ratio was 84.6%. Confirmatory and exploratory factor analysis showed moderate construct validity. Convergent validity showed low correlation between the questionnaire items. Regarding the answers received, it was found that only 55.3% of the respondents received formal training on hand hygiene during the last three years prior to the study. Furthermore, 74.0% of them used alcohol-based solutions routinely. Only 54.3% of the participants presented an acceptable level of hand hygiene knowledge.

The translation and validation of the WHO questionnaire resulted in an acceptable, reliable, and valid instrument. The survey showed that hand hygiene is rather a matter of habit, than of knowledge, and that there is great need of more organized training.