Background: Hand hygiene (HH) is needed for healthcare workers (HCWs) at the operating room (OR) to prevent their hands from becoming reservoirs for pathogenic. This study was carried out to investigate the level of knowledge and perception and the barriers to HH and to identify the factors that affect HH. Methods: This was a cross-sectional study. The participants were those who worked at an OR at a teaching hospital. A total of 244 HCWs were enrolled, among whom we distributed a selfadministered survey regarding the knowledge, perception, and barriers and adherence of to HH. Finally, 159 survey sheets were retrieved, and a concurrent direct-observation of HH was conducted. Results: HH adherence was differed from the method using self-administration or direct observation. HH adherence accounted for 83.4% of the survey respondents and 68.5% with direct observation, with statistical significance (P<.001). This presented confirmative results in doctors (85.4% vs. 52.5%). The HH of HCWs in surgery (85.8%) was significantly higher than that of HCWs in anesthesia (76.0%). A multivariate hierarchical linear regression model was constructed by three-layer models consisting of demographic, occupational, and motivational factors. It revealed that perception, barrier, type of duty (surgery vs. anesthesia), and years of career experience were affecting factors of HH adherence.
Conclusion:The HH adherence of HCWs in anesthesia was lower than of those in surgery, presenting a wide gap between self-administration and direct observation. The HH perception increased with self-administered HH, but barriers acted reversely. Therefore, improvement on perception and decrease of the barriers is necessary to raise the HH adherence of HCWs in the OR.