Knowledge, Attitudes, and Practice of Hand Hygiene Guidelines among Health Care Providers: A National Perspective from Saudi Arabia: Practice of Hand Hygiene Guidelines among Health Care Providers

Background: Given that, the majority of Health Care Associated Infections (HCAIs) are transmitted directly through the hands of healthcare providers (HCPs). Improving HCPs Hand Hygiene (HH) is a logical and cost-effective way to prevent HCAIs and restrict the transmission of microorganisms. Objectives: To assess knowledge, attitudes and practice of HH guidelines, and barriers of compliance among a national sample of HCPs in Saudi Arabia. Methods: Two independent national studies were conducted during approximately the same period in different health care facilities selected from each of the 20 health regions of Saudi Arabia. The first is a multicenter cross-sectional study where a total of 7,153 HCPs completed a self-administered questionnaire regarding hand hygiene. The second was an observational study of HCP’s HH practices conducted using the WHO patient safety observation form. A total of 82,250 observations were made in critical care units at 268 hospitals in each region. All analyses were performed with SPSS, version 21. Results: The average HH knowledge score was 65.5%; however, there were significant differences in knowledge levels across groups. Nearly all reported positive attitudes toward HH as well as adhering to the guidelines regularly. The overall observed compliance rate was 68.9% (95% CI: 67.7%-70.2%), with statistically significant variation between different departments and HCP categories, with nurses having overall higher compliance than physicians (71.9% vs. 65.7%). Conclusion: Findings indicate some gaps in HH knowledge. Further investigation is recommended into the relationship between HH compliance and actual infection rates with pre- and post-intervention measures.