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Hand hygiene knowledge in long-term care facilities (LTCFS): a multicentre pilot study

Introduction / objectives

Until now, promotion of hand hygiene was mostly targeted to acute care facilities. Yet, little is known about knowledge of hand hygiene recommendations in chronic care facilities. The objective of this study was to evaluate hand hygiene knowledge in health care workers in Flemish LTCFs.


We developed a questionnaire based on campaign material that was distributed by the Flemish government in order to improve hand hygiene in LTCFs. The quiz, based on the most recent WHO guidelines contains 18 specific healthcare related situations in which hand hygiene or wearing gloves is recommended. It was presented to a stratified sample of personnel from two LTCFs in January 2011, prior to continuing education regarding hand hygiene. Frequencies and total scores were calculated. Mann-Whitney test was used to compare scores in both LTCFs. Statistical analyses were performed using PASW Statistics 18 (SPSS, Chicago, IL, US).


81 LTCF health care workers participated. Response was 100%. The mean score was 9.21 on 18 items (Standard Deviation 2.58, min. 1, max. 15) or 51%. No significant differences were found between the two LTCFs. Some items scored below 50%. These items were related to four hand hygiene indication groups: ‘before patient contact’ (e.g. hygienic care, taking blood pressure, feeding), ‘after glove removal’, ‘before a clean/aseptic procedure’ (e.g. wound care and IM injections) and ‘in case of risk of contact with body fluids’ (e.g. oral medication administration).


Our study identified several gaps in the knowledge about hand hygiene recommendations in LTCF health care workers. These results indicate substantial room for improvement in this specific group of HCWs.

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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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De Wandel, D., Vogelaers, D. & Blot, S. Hand hygiene knowledge in long-term care facilities (LTCFS): a multicentre pilot study. BMC Proc 5 (Suppl 6), P163 (2011).

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