title: Self-reported hand hygiene practices, and feasibility and acceptability of alcohol-based hand rubs among village healthcare workers in Inner Mongolia, China.
abstract: BACKGROUND
  Good hand hygiene is critical to reduce the risk of healthcare-associated infections. Limited data are available on hand hygiene practices from rural healthcare systems in China.
  
  
  OBJECTIVE
  To assess the feasibility and acceptability of sanitizing hands with alcohol-based hand rubs (ABHRs) among Chinese village healthcare workers, and to assess their hand hygiene practice.
  
  
  METHODS
  Five hundred bottles of ABHR were given to village healthcare workers in Inner Mongolia, China. Standardized questionnaires collected information on their work load, availability, and usage of hand hygiene facilities, and knowledge, attitudes, and practices of hand hygiene.
  
  
  RESULTS
  In all, 369 (64.2%) participants completed the questionnaire. Although 84.5% of the ABHR recipients believed that receiving the ABHR improved their hand hygiene practice, 78.8% of recipients would pay no more than US$1.5 out of their own pocket (actual cost US$4). The majority (77.2%) who provided medical care at patients' homes never carried hand rubs with them outside their clinics. In general, self-reported hand hygiene compliance was suboptimal, and the lowest compliance was 'before touching a patient'. Reported top three complaints with using ABHR were skin irritation, splashing, and unpleasant residual. Village doctors with less experience practised less hand hygiene.
  
  
  CONCLUSIONS
  The overall acceptance of ABHR among the village healthcare workers is high as long as it is provided to them for free/low cost, but their overall hand hygiene practice is suboptimal. Hand hygiene education and training is needed in settings outside of traditional healthcare facilities.
authors.affiliation: Global Disease Detection Program, United States Centers for Disease Control and Prevention, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.affiliation: Bayan Nur TB Dispensary, Bayan Nur Infectious Disease Hospital, Bayan Nur, Inner Mongolia Autonomous Region, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Bayan Nur TB Dispensary, Bayan Nur Infectious Disease Hospital, Bayan Nur, Inner Mongolia Autonomous Region, China.
authors.forename: D
authors.initials: D
authors.lastname: Yan
authors.affiliation: Global Disease Detection Program, United States Centers for Disease Control and Prevention, Beijing, China; Global Disease Detection Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: crao@cdc.gov.
authors.forename: C Y
authors.initials: CY
authors.lastname: Rao
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D001291:Attitude of Health Personnel; D002681:China; D002983:Clinical Competence; D003428:Cross Infection / Q000517:prevention & control; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006235:Hand Disinfection / Q000379:methods*; D063373:Hand Hygiene / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012423:Rural Health; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D000431:Ethanol
keywords: Hand hygiene; Healthcare-associated infection; Village doctors