Healthcare workers' knowledge, beliefs, and thoughts on improving hand hygiene practices in nursing homes.

Background: Hand hygiene adherence in nursing homes is too low to prevent transmission of healthcare-associated infections, and it is difficult to achieve long-lasting increased hand hygiene adherence. There is a need for more information about healthcare workers' knowledge, beliefs, and routines in hand hygiene practices to better understand how to improve them. Methods: Five second-year students in a bachelor's degree in nursing conducted nine interviews of healthcare workers as part of an intervention to increase hand hygiene adherence in a nursing home ward. Results: Four major topics emerged from the analyses of the transcript data: hand hygiene is important, inadequate knowledge, barriers to infection practices, and suggestions for improvement. Discussion: The healthcare workers knew that proper hand hygiene was important for preventing the spread of infections, but they had limited knowledge of when and how to perform it. They saw that other healthcare workers did not perform hand hygiene when it was required, but few of them wanted to correct or remind 'the others' of what was correct. Conclusion: The healthcare workers experienced stress, and tiredness and said it was challenging to balance providing good care for residents with proper hand hygiene. Nursing home leaders should ensure staff receive proper training, regular reminders, and access to hand hygiene resources.