Knowledge, Attitude, and Practice of Hand Hygiene among Healthcare Workers during the COVID-19 Pandemic in referral hospitals: A case study from Southern Iran

Abstract Background: Hand hygiene compliance is the simplest, the most important, and the most cost-effective way to prevent and reduce healthcare-associated infections. Its implementation requires adequate knowledge and awareness. This study aimed to assess the knowledge, attitude, and practice of hand hygiene among healthcare workers in referral hospitals of Bushehr province, southern Iran, in 2021. Method: This is a cross-sectional descriptive-analytical survey of 205 medical staff. A stratified sampling technique was used to select the respondents. They completed the questionnaire, which included demographic information (age, gender, education, etc.) and questions in three sections to assess the level of knowledge, attitude, and practice of medical staff. Results: The results showed that the mean age of the population studied was 34.18 ± 7.15 years. Of these, 63.9% were female, most of the participants (80.0%) were married, nurses (66.8%), had a bachelor's degree (70.2%), and worked in the COVID-19 wards (51.7%). The mean scores for staff knowledge, attitude, and practice of hand hygiene among the staff were 7.7 ± 2.4 (from 0-12), 69.7 ± 7.1 (from 19-95) and 56.8 ± 9.1 (from 14-70), respectively, indicating relatively adequate knowledge among medical staff. In the non-COVID-19 wards, staff compliance with hand hygiene was higher than in the COVID-19 wards (P<0.001). There was a direct relationship between hand hygiene knowledge, attitude, and practice scores and education, gender, occupation, and type of employment (P value <0.05). Conclusion: Due to staff shortages in hospitals and overcrowding in emergency departments and wards such as COVID-19, hand hygiene is usually not practiced because staff believe that their duties of caring for patients are more important than cleaning their hands, or that wearing gloves instead of washing their hands is sufficient. Ongoing infection control education programs for healthcare workers, especially medical staff, are essential.