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Hand Hygiene Practices among Doctors and Nurses at Emergency departments of Mina Hospitals during Hajj Season 1433 H (2012 G), Saudi Arabia.


Nosocomial infections have been recognized for more than a century as a critical problem affecting the quality of health care provided in hospitals. At least one third of all nosocomial infections are preventable by optimal infection prevention programs. A significant proportion of infections result from cross-contamination by the hands of Health Care Workers (HCWs). This study was conducted to observe both the provided facilities for hand hygiene and compliance of Hand Hygiene practices of HCWs working at the Emergency departments of the four Mina hospitals during Hajj season of 1433H (2012).


An observational descriptive cross-sectional study was conducted at the Emergency Departments of four Mina Hospitals during Hajj season. The sample included all doctors and nurses working at these departments (n= 243). Study participants were randomly selected for observation, 1or 2 for every single hour of work shift 24 hours (Day) at each Emergency Department, and was unobtrusively observed for following the World Health Organisation's (WHO) 5 Moments for hand hygiene. The study was carried out over a period of two days.


Of the total number observed for hand hygiene compliance, 45.8% were doctors, 45.3% were nurses. The overall compliance rate was 45.5%, Altware hospital recorded the highest adherence to hand hygiene (64.1%), while Alwade hospital recorded the lowest (30.8%). Hand hygiene adherence was lower among male doctors, and the difference between male and female doctors was statistically significant. The total moments observed were 1215 moments. The distribution among 5 moment show high hand hygiene adherence observed at moment after body fluid exposure risk (87.9%). Alcohol hand rub was the favoured method used for hand hygiene (77.4%) compared with washing with soap and water (8.4%). Cleaning tools significantly varied across hospitals. We found that there were 4 sinks at Alwade hospital emergency department and 6 sinks at Altware. Also, at both hospitals there was liquid soap for cleaning, but was available at some sinks not all. At both hospitals HCWs used disposable paper for hand drying. As regards to availability of alcohol hands rub (AHR) which was available abundantly at Altware and Aljaser hospitals, but only at some sites at Alwade and Alshara hospitals. Hand hygiene posters were completely available at Alwade, Aljaser and Alshara hospitals, but at Altware hospital they were available at some sites only.


The overall hand hygiene compliance rate observed at the Emergency departments of the four Mina hospitals during Hajj season of 2012 was45.5%. There was a difference between the four hospitals hand hygiene facilities and instruments which reflects in the compliance rate, showing a higher compliance rate where there are available hand hygiene facilities. Further study is needed to explore the reasons for non-compliance.