KNOWLEDGE, ATTITUDE AND PRACTICE PATTERNS OF HAND WASHING IN MAJOR PUBLIC SECTOR HOSPITALS OF KARACHI

ABSTRACT

Objectives:  i) To study the knowledge, attitude, and practice pattern of hand washing in medical professionals at Government hospitals of Karachi. ii) To assess any difference of knowledge, attitude, and practice pattern at different levels of health care workers. iii) To assess the availability of hand washing facilities in different Wards/OPD’s, Casualty/ICU of government hospitals of Karachi.  

Settings:  i) Civil Hospital, ii) Jinnah Postgraduate Medical Center, iii) National Institute of Child Health iv) Layari General Hospital, v) Sindh government Hospital, Liaquatabad, vi) Sindh Government Qatar Hospital.(10 wards and 10 OPD’s of the same units i.e. two units each of Medical and Surgery, one unit each of ENT, Eye, Dermatology, Gynea, Peads and Causality /Intensive care unit.)

Methods: The study was conducted after getting written consent of the Director/Medical superintendent of the hospital. Similarly a written consent of the individual was also obtained. From each unit, 5 staff members were selected including 2 doctors (one senior and one junior) and 3 paramedics (one head/ Staff nurse, one nurse/student nurse and one dispenser/dresser/trainee technician.). A pre-coded proforma was used to collect the information; besides this an observational questionnaire was also filled to see the actual facilities available and the practice pattern of the staff.

Results: Of the 386 individuals interviewed, only 68.8% had sufficient knowledge about the benefits of hand washing. The facilities for hand washing were available at only 16.8% (16/96) units. Although, overall 59% said that they were adopting the practice of hand washing after examination of every patient but when observed only 8.9% doctors and staff were practicing hand washing regularly. Majority of the users of hand washing practices (62.7%) used the toilet soap, which they had purchased themselves (significantly higher). Only 33.4% individuals thought that this practice of soap and water was adequate whereas others (66.6%) did not think so. Attitude of 48.7% doctors and 66.2% paramedical staff was positive and they showed interest in adopting the hand washing practices if these were provided to them regularly. Main reason for not washing hands was heavy rush of patients and lack of environment of this practice in the hospital.  

Conclusion: The report shows that to prevent nosocomial infection the hospital management should provide hand-washing facilities on regular basis at all sites where patients are examined. Senior should make sure that they adhere to this practice and also keep a check on their juniors. Health education should be provided regularly through print and visual media and workshops