الفهرس 
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Abstract
Healthcare-associated infections (HCAIs) are one of the adverse events beside the adverse drug events and surgical complications that not only affect hospitalized patients but also have adverse effect on HCWs. The Agency for Health Care Research and Quality reported that HCAIs are one of the top 10 leading causes of death in the USA.
HCAIs are preventable, if effective structures, systems and procedures are in place to manage the potential risks arising from the environment and activities within the hospital. Hand hygiene, the cost-effective preventive measure, is a foundation in these SPs across all settings from primary healthcare units to advanced healthcare systems.
Despite the HH procedure is simple and effective still there is decrease in compliance rate which is believed to be due to lack of HH products and requirements, personal attitude factors as skin irritation, the belief that there is not an indication for HH, patient care is more important or time is not enough for it, forgetfulness, work overload or due to the ignorance of guidelines and lack of scientific information.
Adherence to effective infection control measures particular HH in PHC settings is essential as the main objective of PHC is preventive. This study aimed to assess gap between self-assessment to the appropriate HH practice and actual compliance by direct observation and its correlation with the knowledge among primary HCWs.
The objectives of this study were to assess the knowledge, attitude and practice of hand hygiene among primary healthcare workers and their actual compliance to HH practice and to assess the efficacy of hand hygiene.
To achieve such objectives, a cross sectional study was conducted among PHCWs in primary care facilities in Kafr Shukr District, Qalyubia Governorate during the form first of January 2019 to the end of June 2019. The final sample was115 participant and the data collected by using the modified WHO questionnaire and a self-structured questionnaire to assess the knowledge, attitude and practice of hand hygiene and a modified version of the WHO observation form to assess compliance and laboratory study was done to the palms/fingers of the participants and examined for microbial growths.
The study revealed the following results:
The overall knowledge score for hand hygiene was moderate, the positive and negative attitude levels of the sample were nearly equal and the self-assessment of HH practice was appropriate among the included healthcare workers
Good knowledge level of the participants was associated with increase their use of alcohol-based HR and increase their appropriate practice.
The attitude and practice of the participants regarding HH were higher among females, nurses and more experienced ones. Previous formal training was significantly associated with increasing the appropriate practice. When the participants’ age exceeded thirty, their attitude becomes statistically significant positive than those aged less than thirty.
Despite of the availability of supportive infrastructure and required resources, the total compliance of the participants to HH practice by direct observation was low 44.7%.
According to WHO ‘My five moments for hand hygiene’, the participants were more adherent to HH practice at moments 3 & 2 and less adherent to moments 1, 4 & 5.
The microbiological results of this study showed the efficacy of hand washing (p<0.001).