HAND HYGIENE KNOWLEDGE, PERCEPTION, AND SELF-REPORTED PERFORMANCE AMONG NURSES IN A TERTIARY CARE HOSPITAL, LAHORE: A CROSS-SECTIONAL STUDY

Abstract

Background: Hand hygiene is considered one of the simplest and most effective measures for preventing healthcare-associated infections (HAIs) and ensuring patient safety. Although clear hand hygiene guidelines are available, compliance among nurses is still inconsistent. Factors such as knowledge, perception, and self-reported performance play an important role in influencing hand hygiene practices in healthcare settings. Objective: This study aimed to assess the hand hygiene knowledge, perception, and self-reported performance among nurses working in a tertiary care hospital in Lahore and to determine the relationship between these variables. Methods: A descriptive cross-sectional study was conducted among 150 nurses working at Bahria International Hospital Lahore and Bahria Orchard Hospital Lahore. Data were collected using the WHO Hand Hygiene Knowledge Questionnaire and the WHO Hand Hygiene Perception Questionnaire (2009 revision). Descriptive statistics including frequencies percentages means and standard deviations were used to summarize the data. Since the data where not normally distributed Spearman's rank correlation test was applied using SPSS version 23. A p-value of <0.05 was considered statistically significant. Results: The findings showed that nurses had a moderately high level of hand hygiene knowledge with a mean score of 16.22 ± 2.33. The mean perception score was 3.09 ± 0.34, indicating generally positive perceptions toward hand hygiene, while the mean self-reported performance score was 8.23 ± 1.46. A moderate positive correlation was found between knowledge and self-reported performance (Spearman's rho = 0.429, p < 0.001). Similarly, perception showed a significant positive correlation with self-reported performance (Spearman's rho = 0.312, p < 0.001). Knowledge and perception were also positively associated, although the relationship was relatively weak (Spearman's rho = 0.213, p = 0.009). Conclusion: The study concludes that better hand hygiene knowledge and positive perceptions are associated with improved self-reported hand hygiene performance among nurses. These findings highlight the importance of regular educational programs continuous training and supportive infection prevention strategies to strengthen hand hygiene practices and improve patient safety in tertiary care hospitals.