Background: Hand hygiene is the most important and effective measure to prevent cross-infection in hospitals. Hand-hygiene campaign must be implemented as a part of infection control program at King Chulalongkorn
Memorial Hospital (KCMH). The behavior, attitudes, and beliefs of health care workers (HCWs) and visitors regarding hand-hygiene practices have never been studied in KCMH.
Objectives: To determine the baseline compliance and assess the attitudes and beliefs regarding hand hygiene of HCWs and visitors in intensive care units (ICUs) at KCMH.
Material and Method: We observed hand-hygiene compliance of HCWs and visitors in ICUs before patient contact for eight hours. A self-administered questionnaire was employed to measure attitudes and beliefs about hand hygiene for two-week period.
Results: Overall hand-hygiene compliance obtained from this observational study was less than 50% and differed markedly among various professional categories of HCWs and visitors. In questionnaire-based study, patient needs perceived as a priority (51.2%) was the most common reason for non-compliance, followed by forgetfulness (35.7%), and skin irritation by hand-hygiene agents (15.5%). Subjects believed to improve their compliance by multiple strategies including available low irritating hand-hygiene agents (53.4%), information of current nosocomial infection rate (49.1%), and easily accessed hand-hygiene supplies (46.3%). Almost all subjects (99.7%) claimed to know correct hand-hygiene techniques. Handwashing with medicated soap was perceived to be the best mean of hand decontamination (37.8%).
Conclusion: Hand-hygiene compliance of HCWs and visitors is unacceptably low. Their knowledge, behavior, attitudes, and beliefs toward hand hygiene need to be improved by the multimodal and multidisciplinary approach.

Keywords: Hand hygiene, Handwashing, Compliance, Attitudes, Nosocomial infection