What question did this study set out to answer?

To assess hand hygiene performance in medical students and the general population, and explore their attitudes and behaviors.

May 10, 2026Journal of Hospital Infection1 citationsOpen Access

Hand hygiene performance in medical students and the general population: objective assessment and behavioural factors

LŠLadislav Štěpánek RTRenata Trajerová LŠLubomír Štěpánek

Key Points

To assess hand hygiene performance in medical students and the general population, and explore their attitudes and behaviors.
Cross-sectional design involving medical students (n=326) and general population (n=216)
Participants performed hand hygiene using fluorescent dye-containing alcohol-based hand rub
Coverage quantified by digital imaging and participants completed a questionnaire.
Mean hand hygiene coverage was 86.4% overall, with medical students at 94.2% and the general population at 74.6% (p<0.001)
Only 37.5% of participants achieved target coverage (95%), with medical students at 58.0% compared to 6.5% in the general population (p<0.001)
Prior hand hygiene training and preference for alcohol-based hand rub significantly predicted achieving target coverage (OR 12.8 and OR 10.8, respectively).

Abstract

Background: Inadequate hand hygiene (HH) remains a major driver of healthcare-associated infections, with implications extending beyond healthcare workers to the general population.Aims: To objectively assess HH performance among medical students, compare it with the general population, and examine associated attitudes and self-reported behaviours.Methods: In this cross-sectional study, third-and fifth-year medical students (n=192 and n=134) and a general population sample (n=216) performed HH using a fluorescent dyecontaining alcohol-based hand rub (ABHR).Coverage was objectively quantified by digital imaging, and participants completed a study-specific questionnaire.Findings: Mean coverage across four hand surfaces was 86.4% overall and higher in medical students than the general population (94.2% vs 74.6%; p<0.001), and in fifth-than third-year students (96.8% vs 92.4%; p<0.001).The dominant palm showed the highest coverage, whereas the dorsum and thumb were most often insufficiently covered.Target coverage (95%) across all surfaces was achieved by 37.5% overall, more frequently in medical students than the general population (58.0%vs 6.5%; p<0.001) and in fifth-than third-year students (75.4% vs 45.8%; p<0.001).Multivariable analysis showed that prior HH training (odds ratio OR 12.8, 95% confidence interval CI 6.4-25.6),ABHR preference (OR 10.8, 95% CI 6.1-19.0),and self-reported adherence to HH technique (OR 1.6, 95% CI 1.0-2.4)independently predicted target coverage.Protection of one's own health predominated across groups; however, medical students more frequently also reported prosocial motives for ABHR. Conclusion:The findings underscore the importance of strengthening HH training, shaping attitudes, and integrating real-time electronic feedback throughout medical education and the population.

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