Abstract:
Background: Hand hygiene is the cornerstone of infection prevention and control practices,
and reduces healthcare-associated infections significantly. However, international
evidence suggests that medical doctors demonstrate poor compliance.
Aim: To explore and compare practices and attitudes towards hand hygiene, particularly
hand rubbing using alcohol-based hand rub (ABHR), among hospital-based physicians in
Ireland between 2007 and 2015.
Methods: In 2007, a random sample of doctors in a large teaching hospital was invited to
complete a postal survey using a validated questionnaire. In 2015, the study was replicated
among all doctors employed in a university hospital group, including the setting of
the original study, using an online survey. Data were analysed using SPSS and Survey
Monkey.
Findings: Predominately positive and improving attitudes and practices were found, with
86% of doctors compliant with hand hygiene before patient contact in 2015, compared
with 58% in 2007. Ninety-one percent of doctors were compliant after patient contact in
2015, compared with 76% in 2007. In 2015, only 39% of respondents reported that they
‘almost always’ used ABHR for hand hygiene. However, this represents 13.5% more than in
2007. Stated barriers to use of ABHR included dermatological issues, poor acceptance,
tolerance and poor availability of ABHR products.
Conclusion: Greater awareness of hand hygiene guidelines and greater governance appear
to have had a positive impact on practice. However, despite this, practice remains suboptimal
and there is scope for substantial improvement. Continued and sustained efforts
are required in order to build on progress achieved since the World Health Organization
hand hygiene guidelines were published in 2009.