Abstract
Introduction
Poor hand hygiene causes 40% of hospital-associated infections (HAIs) and half of deaths in children aged less than two weeks. The global infection risk in healthcare delivery is high, with low hand hygiene compliance rates in developing countries. Cambodia's Ministry of Health has launched infection prevention and control (IPC) guidelines, but challenges with poor understanding remain and hinder IPC implementation. This study aimed to assess hand hygiene practices and associated factors among healthcare providers (HCPs) in Kep Provincial Hospital, Cambodia.
Methods
This cross-sectional study was conducted among healthcare providers (HCPs) in Kep Provincial Hospital from May-July 2023. Direct spot-checklist observation at any of the 5 moments for the hand hygiene concept was carried out to describe hand hygiene practices (HHP). Then, questionnaires were used to assess self-reported HHP and associated barriers and facilitators. The total number of hands hygiene opportunities observed was 207 among 27 HCPs. All 27 HCPs responded to the questionnaires on a 5-point Likert scale.
Results
The mean age of the HCPs was 33.5 years (SD=7.8). The overall percentage of HHP was 36.7%, but when stratified, the HHP varied by professional stats: medical doctor (25.4%), midwife (37.5%), and nurse (45.0%). HHP was high after body fluid exposure (76.9%), and after patient contact (64.8%). It was low before patient contact (9.1%), before the aseptic procedure (12.9%), and after touching the surroundings (29.3%). HHP was significantly associated with WHO five moments (p<0.001) especially high after being exposed to body fluid (76.9%) and after touching patients (64.8%). HCPs with less than 5 years of working experience (p<0.05), younger than 25 years of age (p<0.05), and being nurse professional (p=0.05) practice hand hygiene better than those with 5 years or more of experience and those over age 25 years respectively. Decision processes (p=0.019) was also significantly associated with HHP.
Conclusion
This study revealed that healthcare providers at Kep Provincial Hospital performed hand hygiene at a lower rate than the WHO standards. Factors such as experience, younger age group, and professional status significantly influenced HHP. This study recommends continuous training for healthcare providers who are over 30 years old), with longer working experience, continued supplying for hand hygiene including alcohol-based hand rubs, and keep reminding and giving feedback on their performance.