title: Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India.
abstract: OBJECTIVE
  To describe self-reported practices and assess knowledge and attitudes regarding hand hygiene among healthcare workers in a rural Indian teaching hospital.
  
  
  METHODS
  A rural teaching hospital and its associated medical and nursing colleges in the district of Ujjain, India.
  
  
  METHODS
  The study population consisted of physicians, nurses, teaching staff, clinical instructors and nursing students. Self-administered questionnaires based on the World Health Organization Guidelines on Hand Hygiene in Healthcare were used.
  
  
  RESULTS
  Out of 489 healthcare workers, 259 participated in the study (response rate = 53%). The proportion of healthcare workers that reported to 'always' practice hand hygiene in the selected situations varied from 40-96% amongst categories. Reported barriers to maintaining good hand hygiene were mainly related to high workload, scarcity of resources, lack of scientific information and the perception that priority is not given to hand hygiene, either on an individual or institutional level. Previous training on the topic had a statistically significant association with self-reported practice (p = 0.001). Ninety three per cent of the respondents were willing to attend training on hand hygiene in the near future.
  
  
  CONCLUSIONS
  Self-reported knowledge and adherence varied between situations, but hand hygiene practices have the potential to improve if the identified constraints could be reduced. Future training should focus on enhancing healthcare workers' knowledge and understanding regarding the importance of persistent practice in all situations.
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Department of Public Health and Environment, R.D. Gardi Medical College, Ujjain, India.|International Center for Health Research, R.D. Gardi Medical College, Ujjain, India.
authors.forename: Vishal
authors.initials: V
authors.lastname: Diwan
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Gustafsson
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Senia
authors.initials: S
authors.lastname: Rosales Klintz
authors.affiliation: Department of Community Medicine, R.D. Gardi Medical College, Ujjain, India.
authors.forename: Sudhir Chandra
authors.initials: SC
authors.lastname: Joshi
authors.affiliation: Department of Microbiology, R.D. Gardi Medical College, Ujjain, India.
authors.forename: Rita
authors.initials: R
authors.lastname: Joshi
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Department of Pharmacology, R.D. Gardi Medical College, Ujjain, India.
authors.forename: Megha
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Department of Microbiology, R.D. Gardi Medical College, Ujjain, India.
authors.forename: Harshada
authors.initials: H
authors.lastname: Shah
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Department of Pediatrics, R.D. Gardi Medical College, Ujjain, India.|Department of Women and Children's Health, International Maternal and Child Health, Unit, Uppsala University, Uppsala, Sweden.
authors.forename: Ashish
authors.initials: A
authors.lastname: Pathak
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Ujjain, India.
authors.forename: Ashok J
authors.initials: AJ
authors.lastname: Tamhankar
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Stålsby Lundborg
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D063373:Hand Hygiene / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D012306:Risk; D012424:Rural Population; D057566:Self Report