Hand hygiene awareness and handwashing effectiveness in caregivers of surgical patients: a cross-sectional study.

Abstract

To evaluate surgical patients' caregivers' hand hygiene knowledge and to examine the discrepancy between reported knowledge and actual hand cleanliness following caregiving activities. Cross-sectional study. General surgery inpatient clinics of a tertiary university-affiliated hospital in Turkey. Caregivers of patients hospitalised in general surgery inpatient clinics; a total of 128 caregivers participated. The primary outcome was caregivers' hand hygiene knowledge score. The secondary outcome was observed hand cleanliness, assessed using fluorescent simulation gel and ultraviolet light across different hand regions. Among the 128 caregivers (65.6% women; mean age 45.7±14.8 years), hand hygiene knowledge was high (mean score: 98.9±3.9). However, observations under ultraviolet light revealed residual contamination, particularly at the wrist. Caregivers with clean wrists had significantly higher knowledge scores than those with contamination (p<0.05). Although caregivers reported frequent handwashing, only 43% reported receiving encouragement from healthcare staff. Inter-observer reliability was excellent, with Cohen's kappa values ranging from 0.864 to 0.913. Although caregivers of surgical patients demonstrated high hand hygiene knowledge, a gap between knowledge and observed practice was identified, particularly in less visible areas such as the wrists. These findings suggest that strategies beyond knowledge transfer, including visual training tools and increased engagement of healthcare professionals, may help improve practical hand hygiene behaviours and infection prevention.