1.1 Background to the study
Prevention and management of infection is the responsibility of all staff working in health care services and an integral element of patient safety programs. Hand washing is one of the monumental infection control measures for the prevention of healthcare-associated infection. Although the technique involved in hand hygiene is simple, compliance with hand hygiene recommendations is poor worldwide (WHO, 2009).
Effective hand hygiene is the simplest proven method to reduce the prevalence of healthcare-associated infections. Unfortunately, the prevalence of these infections continue to rise and it is estimated that annually about hundreds of millions of patients suffer from healthcare-associated infection the world over (Gilbert, 2014). Therefore, infection control is necessary to reduce the high level of healthcare-associated infections and the importance of hand hygiene in the control of infection cannot be overemphasized.
Hand hygiene is a general term referring to any action of hand cleaning by using water and detergent and or the use of alcohol based hand sanitizers for the removal of transient microorganisms from one’s hands (Pitte, Altegranzi & Boyce, 2009). Although many communities have a guideline on hand hygiene for healthcare settings, many researchers have found that measuring adherence to the hand hygiene guidelines is not a simple task. Experts in quality improvement have suggested that a multidisciplinary strategy is necessary to improve hand hygiene including training protocols, routine observation, and feedback (Katama, 2011).
Healthcare-associated infections are a serious problem in healthcare services as they contribute to prolonged hospital stays, long-term disability, mortality in most cases, and excessive healthcare costs. Most healthcare-associated infections can be transmitted from patient to patient through the hands of healthcare workers. In other words, healthcare workers' hands due to poor hygiene are most usually the vehicle for the transmission of healthcare-associated infections (Askarian, Vadollahi & Asjadian, 2012).