OBJECTIVE: To evaluate the compliance on hand-hygiene and related factors among healthcare providers working at secondary and tertiary hospitals in Chengdu. METHODS: On-site observations regarding hand-hygiene compliance and facilities were conducted in 6 hospitals in Chengdu. Doctors and nurses were asked and recorded about their knowledge regarding hand-hygiene. RESULTS: Of 1535 activities where hand-hygiene was deemed necessary, under observating healthcare providers would perform hand-hygiene procedures 17.8% of the time (12.8% of the time before touching a patient, 21.0% of the time before touching objects around a patient, 27.3% of the time after touching a patient, and 31.5% of the time after removing gloves). Only 2.2% of the treating rooms were equipped with foot-operated or automatic faucets;of these only 24.5% had soap or alcohol-based hand-sanitizer, and 6.3% had paper towel or other hand-drying equipment. 92.8% of the healthcare providers knew of the six-step method on hand-washing. More than 90.0% of the healthcare providers knew that both palm and back of the hands as well as the front and back of the fingers should be washed. However, only 22.8% knew that the hand-washing procedure should last ≥ 15 seconds. Rates on hand hygiene among chief or more senior physicians (14.6%), attending physicians (9.2%) and junior doctors (15.6%), nurses in chief (25.0%), senior nurses (26.3%) and junior nurses (20.5%) showed no significant differences (P > 0.05). Similarly, scores on related knowledge between chief or senior physicians (12.4 ± 3.2), attending physicians (13.6 ± 3.3) and junior doctors (13.4 ± 2.9), nurses in charge (15.2 ± 2.0), senior nurses (14.8 ± 2.1) and junior nurses (14.3 ± 2.6) also showed no significant differences (P > 0.05). Rate on hand hygiene among nurses (22.7%) was significantly higher than that of the doctors (13.6%). Rate of hand hygiene among 50 - 59 years old healthcare providers (7.4%) was significantly lower than those of all the other age groups (17.1% - 25.0%); rate of female health care providers (19.5%) was significantly higher than that of males (13.8%). Similarly, the nurse's knowledge score (14.7 ± 2.3) was significantly higher than that of the doctors (13.2 ± 3.1). Among 50 - 59 years old healthcare providers, the rate was (12.2 ± 3.8) significantly lower than that of 20 - 29 (14.0 ± 2.6), 30 - 39 (14.3 ± 2.9) and 40 - 49 year olds (13.8 ± 2.7). Again, the knowledge score of females (14.5 ± 2.5) was significantly higher than that of males (12.7 ± 3.2) (P < 0.05). CONCLUSION: The high-level knowledge on hand-hygiene among healthcare providers in this area did not translate into good practices. Also, most of the hospitals had poor hand-hygiene equipment. We recommend that training and periodic monitoring be conducted, and hand-hygiene equipment be improved to facilitate hand-hygiene practices among healthcare providers.
OBJECTIVE: To evaluate the compliance on hand-hygiene and related factors among healthcare providers working at secondary and tertiary hospitals in Chengdu. METHODS: On-site observations regarding hand-hygiene compliance and facilities were conducted in 6 hospitals in Chengdu. Doctors and nurses were asked and recorded about their knowledge regarding hand-hygiene. RESULTS: Of 1535 activities where hand-hygiene was deemed necessary, under observating healthcare providers would perform hand-hygiene procedures 17.8% of the time (12.8% of the time before touching a patient, 21.0% of the time before touching objects around a patient, 27.3% of the time after touching a patient, and 31.5% of the time after removing gloves). Only 2.2% of the treating rooms were equipped with foot-operated or automatic faucets;of these only 24.5% had soap or alcohol-based hand-sanitizer, and 6.3% had paper towel or other hand-drying equipment. 92.8% of the healthcare providers knew of the six-step method on hand-washing. More than 90.0% of the healthcare providers knew that both palm and back of the hands as well as the front and back of the fingers should be washed. However, only 22.8% knew that the hand-washing procedure should last ≥ 15 seconds. Rates on hand hygiene among chief or more senior physicians (14.6%), attending physicians (9.2%) and junior doctors (15.6%), nurses in chief (25.0%), senior nurses (26.3%) and junior nurses (20.5%) showed no significant differences (P > 0.05). Similarly, scores on related knowledge between chief or senior physicians (12.4 ± 3.2), attending physicians (13.6 ± 3.3) and junior doctors (13.4 ± 2.9), nurses in charge (15.2 ± 2.0), senior nurses (14.8 ± 2.1) and junior nurses (14.3 ± 2.6) also showed no significant differences (P > 0.05). Rate on hand hygiene among nurses (22.7%) was significantly higher than that of the doctors (13.6%). Rate of hand hygiene among 50 - 59 years old healthcare providers (7.4%) was significantly lower than those of all the other age groups (17.1% - 25.0%); rate of female health care providers (19.5%) was significantly higher than that of males (13.8%). Similarly, the nurse's knowledge score (14.7 ± 2.3) was significantly higher than that of the doctors (13.2 ± 3.1). Among 50 - 59 years old healthcare providers, the rate was (12.2 ± 3.8) significantly lower than that of 20 - 29 (14.0 ± 2.6), 30 - 39 (14.3 ± 2.9) and 40 - 49 year olds (13.8 ± 2.7). Again, the knowledge score of females (14.5 ± 2.5) was significantly higher than that of males (12.7 ± 3.2) (P < 0.05). CONCLUSION: The high-level knowledge on hand-hygiene among healthcare providers in this area did not translate into good practices. Also, most of the hospitals had poor hand-hygiene equipment. We recommend that training and periodic monitoring be conducted, and hand-hygiene equipment be improved to facilitate hand-hygiene practices among healthcare providers.