A cross-sectional survey of nursing home resident hand hygiene knowledge, hand hygiene habits, and bathing practices

Objective: To characterize nursing home (NH) resident hand hygiene knowledge, hand hygiene habits, and bathing practices to inform intervention strategies. Design: Cross-sectional survey. Setting: Twenty geographically diverse NHs between December 2023 and July 2024. Participants: NH residents. Methods: The survey was administered verbally to NH residents and consisted of 22 questions pertaining to residents’ hand hygiene knowledge, hand hygiene habits at their previous residence and at the NH, and bathing practices at the NH. Results: Among the 495 NH residents who completed the survey, 54% were short-stay/temporary residents, 65% were female, and 79% were aged 70 years or older. Less than a third (29%) of the residents answered all three hand hygiene knowledge-based questions correctly. Residents washed their hands less often at the NH compared to their previous residence. Residents also washed their hands with running water less frequently at the NH (81% vs. 98%). Thirty percent of residents reported facing challenges with hand hygiene at the NH with 53% of the responses mentioning mobility impairments as the main reason why. Additionally, residents facing challenges with hand hygiene had a lower frequency of hand hygiene at the NH. Half (51%) of the residents reported bathing less at the NH compared to their previous residence with NH policy being the most commonly reported reason encompassing 54% of the responses. Conclusions: NH residents perform hand hygiene and bathe less frequently at the NH. Our multi-site study identified multiple barriers to resident hand hygiene and bathing that can be modifiable through practice or policy changes.