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Healthcare Workers' Knowledge and Attitudes Regarding the World Health Organization's "My 5 Moments for Hand Hygiene": Evidence From a Vietnamese Central General Hospital

  • Van Nguyen, Huy (Graduate School of Public Health, St. Luke's International University) ;
  • Tran, Hieu Trung (Institute for Preventive Medicine and Public Health, Hanoi Medical University) ;
  • Khuong, Long Quynh (Center for Population Health Science, Hanoi University of Public Health) ;
  • Van Nguyen, Thanh (Institute for Preventive Medicine and Public Health, Hanoi Medical University) ;
  • Ho, Na Thi Nhi (School of Nursing, Duy Tan University) ;
  • Dao, An Thi Minh (Institute for Preventive Medicine and Public Health, Hanoi Medical University) ;
  • Van Hoang, Minh (Department of Health Economics, Hanoi University of Public Health)
  • Received : 2019.11.25
  • Accepted : 2020.04.09
  • Published : 2020.07.31

Abstract

Objectives: Although the World Health Organization (WHO) initiative "My 5 Moments for Hand Hygiene" has been lauded as effective in preventing hospital-associated infections, little is known about healthcare workers (HCWs)' hand hygiene behavior. In this study, we sought to assess knowledge and attitudes towards the concepts in this initiative, as well as associated factors, among Vietnamese HCWs at a general hospital. Methods: A structured questionnaire was administered to HCWs at a central Vietnamese general hospital in 2015. Multiple logistic regression analysis was used to identify factors associated with HCWs' knowledge and attitudes towards hand hygiene. Results: Of 120 respondents, 65.8% and 67.5% demonstrated appropriate knowledge and a positive attitude, respectively, regarding all 5 hand hygiene moments. Logistic regression indicated better knowledge of hand hygiene in workers who were over 30 years old, who were direct HCWs (rather than managers), who had frequent access to clinical information, and who received their clinical information from training. Those who worked in infectious and tropical disease wards, who had frequent access to clinical information, and who received information from training were more likely to have a positive attitude towards hand hygiene than their counterparts. Conclusions: Although many Vietnamese HCWs displayed moderate knowledge and positive attitudes towards the WHO hand hygiene guidelines, a key gap remained. Regular education and training programs are needed to increase knowledge and to improve attitudes and practices towards hand hygiene. Furthermore, a combination of multimodal strategies and locally-adapted interventions is needed for sustainable hand hygiene adherence.

Keywords

References

  1. World Health Organization. WHO guidelines on hand hygiene in health care: a summary. First global patient safety challenge clean care is safer care; 2009 [cited 2015 Jul 1]. Available from: https://www.who.int/gpsc/5may/tools/who_guidelines-handhygiene_summary.pdf?ua=1.
  2. Maroldi MA, Felix AM, Dias AA, Kawagoe JY, Padoveze MC, Ferreira SA, et al. Adherence to precautions for preventing the transmission of microorganisms in primary health care: a qualitative study. BMC Nurs 2017;16:49. https://doi.org/10.1186/s12912-017-0245-z
  3. Huis A, van Achterberg T, de Bruin M, Grol R, Schoonhoven L, Hulscher M. A systematic review of hand hygiene improvement strategies: a behavioural approach. Implement Sci 2012;7:92. https://doi.org/10.1186/1748-5908-7-92
  4. Grayson ML, Russo PL, Cruickshank M, Bear JL, Gee CA, Hughes CF, et al. Outcomes from the first 2 years of the Australian National Hand Hygiene Initiative. Med J Aust 2011;195(10):615-619. https://doi.org/10.5694/mja11.10747
  5. Allegranzi B, Gayet-Ageron A, Damani N, Bengaly L, McLaws ML, Moro ML, et al. Global implementation of WHO's multimodal strategy for improvement of hand hygiene: a quasi-experimental study. Lancet Infect Dis 2013;13(10):843-851. https://doi.org/10.1016/S1473-3099(13)70163-4
  6. Allegranzi B, Sax H, Bengaly L, Richet H, Minta DK, Chraiti MN, et al. Successful implementation of the World Health Organization hand hygiene improvement strategy in a referral hospital in Mali, Africa. Infect Control Hosp Epidemiol 2010;31(2): 133-141. https://doi.org/10.1086/649796
  7. Eiamsitrakoon T, Apisarnthanarak A, Nuallaong W, Khawcharoenporn T, Mundy LM. Hand hygiene behavior: translating behavioral research into infection control practice. Infect Control Hosp Epidemiol 2013;34(11):1137-1145. https://doi.org/10.1086/673446
  8. Wasswa P, Nalwadda CK, Buregyeya E, Gitta SN, Anguzu P, Nuwaha F. Implementation of infection control in health facilities in Arua district, Uganda: a cross-sectional study. BMC Infect Dis 2015;15:268. https://doi.org/10.1186/s12879-015-0999-4
  9. Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet 2011;377(9761):228-241. https://doi.org/10.1016/S0140-6736(10)61458-4
  10. Thu TA, Anh NQ, Chau NQ, Hung NV. Knowledge, attitude and practices regarding standard and isolation precautions among Vietnamese health care workers: a multicenter cross-sectional survey. Intern Med Open Access 2012;2(4):115.
  11. Thu TA, Hung NV, Quang NN., Archibald, LK, Thuy l, Harun-Or-Rashid, et al. A point-prevalence study on healthcare-associated infections in Vietnam: public health implications. Infect Control Hosp Epidemiol 2011;32(10):1039-1041. https://doi.org/10.1086/661915
  12. Thi Anh Thu L, Thi Hong Thoa V, Thi Van Trang D, Phuc Tien N, Thuy Van D, Thi Kim Anh L, et al. Cost-effectiveness of a hand hygiene program on health care-associated infections in intensive care patients at a tertiary care hospital in Vietnam. Am J Infect Control 2015;43(12):e93-e99. https://doi.org/10.1016/j.ajic.2015.08.006
  13. Salmon S, Tran HL, Bui DP, Pittet D, McLaws ML. Beginning the journey of hand hygiene compliance monitoring at a 2,100-bed tertiary hospital in Vietnam. Am J Infect Control 2014; 42(1):71-73. https://doi.org/10.1016/j.ajic.2013.07.011
  14. Vietnamese Ministry of Health. Standard prevention procedure instructions in health facilities; 2012 [cited 2015 Jul 1]. Available from: www.kcb.vn/wp-content/uploads/2015/07/3.huong-dan-phong-ngua-chuan.pdf (Vietnamese).
  15. Tenna A, Stenehjem EA, Margoles L, Kacha E, Blumberg HM, Kempker RR. Infection control knowledge, attitudes, and practices among healthcare workers in Addis Ababa, Ethiopia. Infect Control Hosp Epidemiol 2013;34(12):1289-1296. https://doi.org/10.1086/673979
  16. Maheshwari V, Kaore NC, Ramnani VK, Gupta SK, Borle A, Kaushal R. A study to assess knowledge and attitude regarding hand hygiene amongst residents and nursing staff in a tertiary health care setting of Bhopal City. J Clin Diagn Res 2014;8(8):DC04-DC07.
  17. Salmon S, McLaws ML. Qualitative findings from focus group discussions on hand hygiene compliance among health care workers in Vietnam. Am J Infect Control 2015;43(10):1086-1091. https://doi.org/10.1016/j.ajic.2015.05.039
  18. Socialist Republic of Vietnam. The labor code of the Socialist Republic of Vietnam; 2012 [cited 2015 Jul 1]. Available from: http://vanban.chinhphu.vn/portal/page/portal/chinhphu/hethongvanban?class_id=1&mode=detail&document_id= 163542 (Vietnamese).
  19. Oh HS. Knowledge, perceptions, and self-reported performance of hand hygiene among registered nurses at community-based hospitals in the Republic of Korea: a cross-sectional multi-center study. J Prev Med Public Health 2018;51(3):121-129. https://doi.org/10.3961/jpmph.17.188
  20. Nabavi M, Alavi-Moghaddam M, Gachkar L, Moeinian M. Knowledge, attitudes, and practices study on hand hygiene among Imam Hossein Hospital's residents in 2013. Iran Red Crescent Med J 2015;17(10):e19606.
  21. Ango UM, Awosan KJ, Adamu H, Salawu S, Sani MM, Ibrahim AH. Knowledge, attitude and practice of hand hygiene among healthcare providers in semi-urban communities of Sokoto State, Nigeria. Int J Trop Dis Health 2017;26(2):1-9.
  22. Asadollahi M, Arshadi Bostanabad M, Jebraili M, Mahallei M, Seyyed Rasooli A, Abdolalipour M. Nurses' knowledge regarding hand hygiene and its individual and organizational predictors. J Caring Sci 2015;4(1):45-53.
  23. Tromp M, Huis A, de Guchteneire I, van der Meer J, van Achterberg T, Hulscher M, et al. The short-term and long-term effectiveness of a multidisciplinary hand hygiene improvement program. Am J Infect Control 2012;40(8):732-736. https://doi.org/10.1016/j.ajic.2011.09.009
  24. Ward DJ. The role of education in the prevention and control of infection: a review of the literature. Nurse Educ Today 2011; 31(1):9-17. https://doi.org/10.1016/j.nedt.2010.03.007
  25. Hung NV, Tuyen LB. A situation on and correlates of knowledge, attitude and practice of standard precautions in some northern hospitals of Vietnam. J Pract Med 2010; 716(5):36-40 (Vietnamese).
  26. Ugwu MC, Muoka O, Okezie UM, Chimezie C, John D, Ezinne Ilo-Nnabuife E, et al. Perceptions, attitude and knowledge of five moments of hand hygiene practices among healthcare workers in Awka Anambra Nigeria. J Infect Dis Diagn 2019; 4(2):1000126.
  27. Sulaiha SA, Ling WY, Chin LJ, Eow WL, MuhamadFaiz S, Tan NC. The lack of effective hand washing practice despite high level of knowledge and awareness in medical students of clinical years. Int E J Sci Med 2010;4(2):18-26.
  28. Nicol PW, Watkins RE, Donovan RJ, Wynaden D, Cadwallader H. The power of vivid experience in hand hygiene compliance. J Hosp Infect 2009;72(1):36-42. https://doi.org/10.1016/j.jhin.2009.01.021
  29. Budimir-Hussey M, Ciprietti L, Ahmed F, Tarola C, Lo A, El-Masri M. Exploring physician hand hygiene practices and perceptions in 2 community-based Canadian hospitals. J Patient Saf 2013;9(3):140-144. https://doi.org/10.1097/PTS.0b013e318283f56d
  30. Yuan CT, Dembry LM, Higa B, Fu M, Wang H, Bradley EH. Perceptions of hand hygiene practices in China. J Hosp Infect 2009;71(2):157-162. https://doi.org/10.1016/j.jhin.2008.09.017
  31. Kingston L, O'Connell NH, Dunne CP. Hand hygiene-related clinical trials reported since 2010: a systematic review. J Hosp Infect 2016;92(4):309-320. https://doi.org/10.1016/j.jhin.2015.11.012
  32. Pan SC, Tien KL, Hung IC, Lin YJ, Yang YL, Yang MC, et al. Patient empowerment in a hand hygiene program: differing points of view between patients/family members and health care workers in Asian culture. Am J Infect Control 2013;41(11): 979-983. https://doi.org/10.1016/j.ajic.2013.02.008
  33. Ofek Shlomai N, Rao S, Patole S. Efficacy of interventions to improve hand hygiene compliance in neonatal units: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis 2015;34(5):887-897. https://doi.org/10.1007/s10096-015-2313-1
  34. Salmon S, Truong AT, Nguyen VH, Pittet D, McLaws ML. Health care workers' hand contamination levels and antibacterial efficacy of different hand hygiene methods used in a Vietnamese hospital. Am J Infect Control 2014;42(2):178-181. https://doi.org/10.1016/j.ajic.2013.07.013

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