Factors Associated with Hand Hygiene of Care Staff Members Who Work at Long-term Healthcare Facilities

Abstract

The purpose of this study was to elucidate the current state of hand hygiene and related factors among caregivers employed at long-term healthcare facilities. Structured observations and a survey using questionnaires were conducted. Among 140 caregivers at five long-term healthcare facilities in one prefecture, 95 caregivers who met the inclusion criteria were included in this study. A total of 668 occasions of hand hygiene performances of the 95 caregivers were observed. Hands were washed at 487 occasions (73%), with the mean time taken to wash hands of 15.6±7.7 s and use of hand disinfectant observed at 181 instances (27%). Investigation of factors related to hand hygiene indicated that being "busy" had the maximum relation to hand washing duration (β=-0.527, p=0.001) and hand hygiene frequency (β=0.362, p=0.001). Being busy decreased the hand washing duration (p=0.001) but increased the hand hygiene frequency (p=0.001). Additional factors related to hand washing duration were caregivers' age (β=0.324, p=0.001) and level of knowledge (β=0.204, p=0.024). Hand hygiene frequency was associated with years of experience in caregiving (β=0.248, p=0.024). In addition, investigation of attitudes toward infection control indicated that those with a positive attitude toward infection control washed their hands for a longer period of time compared with those with a negative attitude toward infection control (p=0.001). Analysis of methods of hand hygiene indicated that caregivers washed their hands more than they used hand disinfectant and hand washing duration was shorter than the recommended duration. These results indicate a need for enhanced hand hygiene, which may be accomplished by providing comprehensive and individualized education that takes into consideration age, experience, knowledge, and attitudes. Placing a priority on hand disinfection, which requires less time than hand washing when caregivers are busy, may ensure that caregivers utilize effective and efficient handwashing methods.