title: Self-reported practices of hand hygiene among the trainees of a teaching hospital in a resource limited country.
abstract: OBJECTIVE
  To determine the compliance of hand hygiene among the trainee physicians of a tertiary care teaching hospital; and to identify physicians' opinion regarding various obstacles in adhering to the hand hygiene principles.
  
  
  METHODS
  Cross-sectional survey was conducted among the Interns (House Officers) and Post Graduate trainee physicians of a tertiary care teaching hospital in a resource limited country. Subjects were consented and selected through non probability convenient sampling. A self-administered questionnaire, based on the hand hygiene guidelines laid down by the World Health Organization (WHO) was used.
  
  
  RESULTS
  A total of 211 questionnaires were completed. Only 4.7% of the physicians reported to decontaminate their hands before having direct contact with their patients. Only 17% claimed to be aware of the WHO recommendations on hand hygiene. Majority of subjects considered "lack of sinks, soap, water and disposable towel" as a major barrier towards hand hygiene adherence. Overall compliance of hand hygiene was found to be 38.8% but it widely varied as a function of patient care activity.
  
  
  CONCLUSIONS
  Hand hygiene practices among trainee physicians were not in line with WHO recommendations. To make a difference, interventions taken to improve awareness alone, won't be sufficient; they have to be supported with improving facilities for hand hygiene.
authors.affiliation: Department of Medicine, Dow Medical College and Civil Hospital, Karachi.
authors.forename: Muhammad Ali
authors.initials: MA
authors.lastname: Anwar
authors.forename: Sana
authors.initials: S
authors.lastname: Rabbi
authors.forename: Muhammad
authors.initials: M
authors.lastname: Masroor
authors.forename: Fouad
authors.initials: F
authors.lastname: Majeed
authors.forename: Marie
authors.initials: M
authors.lastname: Andrades
authors.forename: Shehla
authors.initials: S
authors.lastname: Baqi
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006235:Hand Disinfection / Q000592:standards; D007722:Health Knowledge, Attitudes, Practice; D006784:Hospitals, Teaching; D006801:Humans; D006920:Hygiene / Q000592:standards; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D010154:Pakistan; D013337:Students, Medical / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014944:World Health Organization; D055815:Young Adult