title: Point of care hand hygiene-where's the rub? A survey of US and Canadian health care workers' knowledge, attitudes, and practices.
abstract: Hand hygiene at the point of care is recognized as a best practice for promoting compliance at the moments when hand hygiene is most critical. The objective of this study was to compare knowledge, attitudes, and practices of US and Canadian frontline health care personnel regarding hand hygiene at the point of care.
  
  
  
  Physicians and nurses in US and Canadian hospitals were invited to complete a 32-question online survey based on evidence supporting point of care hand hygiene. Eligible health care personnel were in direct clinical practice at least 50% of the time.
  
  
  
  Three hundred fifty frontline caregivers completed the survey. Among respondents, 57.1% were from the United States and 42.9% were from Canada. Respondents were evenly distributed between physician and nurses. The US and Canadian respondents gave identical ranking to their perceived barriers to hand hygiene compliance. More than half of the respondents from both the United States and Canada agreed or strongly agreed that they would be more likely to clean their hands when recommended if alcohol-based handrub was closer to the patient.
  
  
  
  This survey demonstrates that similarities between Canada and the United States were more common than not, and the survey raises, or suggests, potential knowledge gaps that require further illumination.
authors.affiliation: Hygiene Science and Public Health Advancements, GOJO Industries, Akron, OH. Electronic address: kirkj@gojo.com.
authors.forename: Jane
authors.initials: J
authors.lastname: Kirk
authors.affiliation: Markham Stouffville Hospital, Markham, Ontario, Canada.
authors.forename: Anson
authors.initials: A
authors.lastname: Kendall
authors.affiliation: Broad Street Solutions, San Diego, CA.
authors.forename: James F
authors.initials: JF
authors.lastname: Marx
authors.affiliation: Infection Prevention, Providence Health Care, Vancouver, British Columbia, Canada.
authors.forename: Ted
authors.initials: T
authors.lastname: Pincock
authors.affiliation: Infection Prevention Consultant, Vermilion, OH.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Young
authors.affiliation: Market Research, GOJO Industries, Akron, OH.
authors.forename: Jillian M
authors.initials: JM
authors.lastname: Hughes
authors.affiliation: College of Nursing, The Ohio State University, Columbus, OH.
authors.forename: Timothy
authors.initials: T
authors.lastname: Landers
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D006235:Hand Disinfection; D063373:Hand Hygiene / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017053:Infection Control; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010820:Physicians; D019095:Point-of-Care Systems; D011795:Surveys and Questionnaires; D014481:United States
keywords: Alcohol based hand sanitizer; Hand sanitizer dispenser location