title: Hand hygiene practices among health care workers (HCWs) in a tertiary care facility in Pune.
abstract: BACKGROUND
  Improper hand hygiene by healthcare workers (HCWs) is responsible for about 40% of nosocomial infections resulting in prolonged illnesses, hospital stays, long-term disability and unexpected high costs on patients and their families, and also lead to a massive additional financial burden on the health-care system.
  
  
  OBJECTIVE
  To assess knowledge and practices regarding hand hygiene among HCWs of a tertiary health care facility.
  
  
  METHODS
  A cross sectional, questionnaire and observation based study was carried out in a tertiary care health care facility in Pune. Based on sample size calculations, 100 HCWs working in medical and surgical wards were studied.
  
  
  RESULTS
  The proportion knowledgeable about hand hygiene practices was 85% and 73% HCWs were of the belief that unclean hands are an important route of cross transmission. WHO guidelines regarding procedure were being followed by 90% for hand washing with soap and water and 64% for alcohol based rubs. Majority preferred hand washing with soap and water over hand rubbing with alcohol based solutions. 21% of HCWs were missing hand hygiene opportunities 1 in 5 times. Heavy workload (38%), non availability (52%) and inaccessibility (9%) of hand hygiene facilities were the common reasons for non-compliance. Availability of 'one time use paper towels' was low (12%).
  
  
  CONCLUSIONS
  Inadequate compliance despite knowledge and false sense of security by alcohol based rubs was seen. A multi disciplinary, multifaceted approach is required to tackle issues of non-compliance.
authors.affiliation: Intern, 166 Military Hospital, C/o 56 APO, India.
authors.forename: V
authors.initials: V
authors.lastname: Anargh
authors.affiliation: Resident, Dept of Community Medicine, AFMC, Pune 411040, India.
authors.forename: Harpreet
authors.initials: H
authors.lastname: Singh
authors.affiliation: Resident, Dept of Community Medicine, AFMC, Pune 411040, India.
authors.forename: Aniket
authors.initials: A
authors.lastname: Kulkarni
authors.affiliation: Director, AFMS (Medical Research), New Delhi, India.
authors.forename: Atul
authors.initials: A
authors.lastname: Kotwal
authors.affiliation: Professor & Head, Dept of Community Medicine, AFMC, Pune 411040, India.
authors.forename: Ajoy
authors.initials: A
authors.lastname: Mahen
keywords: Hand hygiene; Health care workers; Nosocomial infections; Tertiary health care facility; Universal precautions