• Simona Kelcikova, Lucia Mazuchova, Lubica Bielena, and Lenka Filova.
• Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovak.
• J Clin Nurs. 2019 Jun 1; 28 (11-12): 2265-2275.

AimTo assess the quality of self-assessment and the attitude of healthcare workers (HCWs) to hand hygiene (HH) as possible factors of unsatisfactory HH compliance in clinical practice.BackgroundNoncompliance of HH causes healthcare-acquired infections (HAI) in patients. It is assumed that HH-related infections make up approximately 80% of all infections in clinical practice. Our observations suggest that self-assessment and attitude might be surprisingly important factors.Design And MethodThe cross-sectional approach using questionnaire and direct observation was applied. We followed STROBE guidelines. In total, questionnaires of 639 HCWs of surgical departments were included in the study, and 127 HCWs had been also directly observed.ResultsHigh self-assessment regarding HH compliance and its knowledge was reported by 74% and 83% of HCWs, respectively. At the same time, only 51% of HCWs positively evaluated their colleagues with respect to HH. Similar to previous studies, we have found significant differences between physicians and nurses regarding the level of self-assessment, attitude and perception of HH. Physicians were more critical in self-assessment and considered HH less important compared to nurses. The observations revealed drawbacks in HH practices. The high level of self-overassessment might be a contributing factor to noncompliance with HH.ConclusionsIt is necessary to establish systematic professional training and education of HCWs in relation to their HH, and to continuously monitor and evaluate the level of self-assessment in clinical practice, mainly in surgery.Relevance To Clinical PracticeA reasonable objective level of self-assessment and attitude to HH are the most important conditions for preventing of HAI in patients.© 2019 John Wiley & Sons Ltd.

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