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PURPOSE: The aim of this is to find out the hand hygiene (HH) knowledge among primary health care workers (PHCWs) in Abha health district, southwestern Saudi Arabia. METHODS: Data were collected through an anonymous self-administered questionnaire. The questionnaire was based on a WHO "Knowledge Questionnaire for Health Care Workers." RESULTS: The study included 478 PHCWs (239 males and 239 females). The sample included 186 physicians, 212 nurses, and 80 technicians. The highest proportion receiving formal training was nurses (82.1%). Females (77.4%) received significantly more training than males (70.3%). Only 59.2% (283) of the HCWs properly identified unclean hands of HCWs as the main route of the cross. Only 26.4% (126) of the HCWs properly identified germs already present on or within the patient as the most frequent source of pathogens in a health-care facility. Only 54.8% (262) of HCWs properly identified 20 s as the minimal time needed for alcohol-based hand rub to kill most germs on hands. CONCLUSION: The study revealed gaps in the knowledge regarding HH. To promote HH at primary health care setting, WHO bundle of multimodal strategies should be adopted including system change; training/education; evaluation and feedback; reminders in the workplace; and institutional safety climate.

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The aim of this study is to measure the degree of compliance with hand hygiene practices among health-care workers (HCWs) in intensive care facilities in Aseer Central Hospital, Abha, Saudi Arabia, before and after a multimodal intervention program based on WHO strategies. Data were collected by direct observation of HCWs while delivering routine care using standardized WHO method: "Five moments for hand hygiene approach". Observations were conducted before (February-April 2011) and after (February-April 2013) the intervention by well-trained, infection-control practitioners during their routine visits. The study included 1182 opportunities (observations) collected before and 2212 opportunities collected after the intervention. The overall, hand hygiene compliance increased significantly from 60.8% (95% CI: 57.9-63.6%) before the intervention to reach 86.4% (95% CI: 84.9-97.8%) post-intervention (P=0.001). The same trend was observed in different intensive care facilities. In logistic regression analyses, HCWs were significantly more compliant (aOR=3.2, 95% CI: 2.6-3.8) after the intervention. Similarly, being a nurse and events after patient contact were significant determinants of compliance. It is important to provide sustained intensified training programs to help embed efficient and effective hand hygiene into all elements of care delivery. New approaches like accountability, motivation and sanctions are needed.

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OBJECTIVES: Hand hygiene is the undisputed single most effective infection control measure. The purpose of the current study was to measure the degree of compliance with hand hygiene practices among health care workers in intensive care facilities at Aseer Central Hospital (ACH), south-western Saudi Arabia. METHODS: Data were collected by direct observation of health care workers in intensive care units delivering routine care, using the standardized World Health Organization method for direct observation "Five moments for hand hygiene" approach. Observations were made during February-April 2011, by well-trained infection control nurses during their routine visits to the units. The moment the observer identified an indication, it was counted as an opportunity to which there should be a corresponding positive or negative action (hand washing). RESULTS: The present study included 536 opportunities (observations) collected from the intensive care unit (ICU), intermediate care unit (IMCU), cardiac care unit (CCU), and pediatric care unit (PICU) of ACH. Observations covered 179 nurses and 34 physicians working in these units. Overall, hand hygiene non-compliance was observed in 41.0%. The study showed that events before contact with the patient (adjusted odds ratio (aOR) 6.575, 95% confidence interval (CI) 4.461-9.691), being a physician (aOR 1.712, 95% CI 1.126-2.989), and work in the IMCU (aOR 2.140, 95% CI 1.202-3.811) were significant risk factors for hand hygiene non-compliance in the hospital. CONCLUSIONS: The observed high figures of hand hygiene non-compliance warrant intensifying education to promote local hand hygiene and training programs to help embed efficient and effective hand hygiene into all elements of care delivery in the intensive care units of ACH.

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