Sagar Manvi, Sharma Sarit, Chaudhary Anurag, Sharma Shruti
Department of Community Medicine, DMC and H, Ludhiana, Punjab, India.
Department of Community Medicine, GMC, Patiala, Punjab, India.
J Anaesthesiol Clin Pharmacol. 2020 Jul-Sep;36(3):359-365. doi: 10.4103/joacp.JOACP_331_19. Epub 2020 Sep 26.
The burden of healthcare-associated infections (HAIs) is very high and compliance with infection control practices is poor in low and middle-income countries (LMICs). Hand hygiene (HH) being the most important measure to prevent HAIs, the present study was conducted to assess the gap in knowledge, perceptions, and practices of healthcare providers (HCPs) regarding HH and also to know the barriers in adherence to HH practices.
This questionnaire-based cross-sectional study was carried out among 400 HCPs for 1 year. HH practices of HCPs were observed by a trained investigator followed by filling of the preformed proforma by HCPs. The quantitative data were analyzed using Epi info (Version 7) statistical software while qualitative analysis was done to generate themes.
The compliance to HH was higher among nurses (78.3%) than consultants (49.5%) and residents (39.1%). Compliance was more in ICUs (71.4%) than wards (58.3%). Knowledge about HH was found to be 73.8% among consultants and 71.6% among residents, whereas HH opportunities availed by them were only 49.5% and 39.1%, respectively revealing a knowledge-practice gap. The main barriers to adherence to HH as perceived by HCPs were lack of awareness despite adequate knowledge, time constraints, heavy workload, and so on.
In our study, we found that despite adequate knowledge, consultants and residents showed lower compliance with HH practices as compared to nurses. Increasing awareness regarding HH guidelines through frequent sensitization sessions decreased workload, and strict surveillance may help in bridging the knowledge-practice gap.
在低收入和中等收入国家（LMICs），医疗保健相关感染（HAIs）的负担非常高，且感染控制措施的依从性较差。手部卫生（HH）是预防HAIs的最重要措施，本研究旨在评估医疗保健提供者（HCPs）在HH方面的知识、认知和实践差距，并了解坚持HH实践的障碍。
这项基于问卷的横断面研究对400名HCPs进行了为期1年的调查。由一名经过培训的调查员观察HCPs的HH实践，然后由HCPs填写预先设计的表格。定量数据使用Epi info（版本7）统计软件进行分析，定性分析用于生成主题。
护士的HH依从性（78.3%）高于顾问（49.5%）和住院医生（39.1%）。重症监护病房（ICUs）的依从性（71.4%）高于病房（58.3%）。顾问中关于HH的知识知晓率为73.8%，住院医生中为71.6%，而他们利用的HH机会分别仅为49.5%和39.1%，这显示出知识与实践之间的差距。HCPs认为坚持HH的主要障碍是尽管有足够的知识但缺乏意识、时间限制、工作量大等。
在我们的研究中，我们发现尽管顾问和住院医生有足够的知识，但与护士相比，他们对HH实践的依从性较低。通过频繁的宣传会议提高对HH指南的认识、减少工作量以及严格的监督可能有助于弥合知识与实践之间的差距。
