Thousands of people die every day around the world from infections acquired while receiving health care. Hands are the main pathway of germ transmission during health care. Hand hygiene is therefore an important measure to avoid the transmission of harmful germs and prevent health care associated infections [1].

Hand hygiene is of paramount importance for prevention of health care associated infections and spread of antimicrobial resistance. There is a need to explore the concept of hand hygiene among cross disciplinary under-graduate health care students. Health care associated infections are a major concern when it comes to patient safety; hand hygiene remains the primary measure to reduce health care associated infections and the spread of antimicrobial resistance across all settings from advanced health care system to local dispensaries in developing countries [2].

Any health care worker, care giver or person involved in direct or indirect patient care needs to be concerned about hand hygiene and should be able to perform it correctly and at right time. Effective hand hygiene is the simplest proven method to reduce the prevalence of health care associated infections.

Unfortunately, the prevalence of these infections continues to rise and it is estimated that annually about hundreds of millions of patients suffer from health care associated infections over the world. Therefore, infection control is necessary to reduce the high levels of healthcare associated infections and the importance of hand hygiene in the control of infections cannot be over emphasized [3,4].

Lack of hand hygiene leads to a serious problem in health care services as they may cause prolonged hospital stay, high mortality, longer term disability and excess health care cost. Most health care associated infections can be transmitted from patient to patient via the hands of health care workers due to poor hand hygiene. This is usual type of vehicle for transmission of health care associated infections [3].

The World Health Organization has issued guidelines for procedural hand washing in order to reduce the prevalence of hospital associated infections but a lack of knowledge among the health care workers is associated with poor compliance [1].

In the present study only 87 out of 150 (58%) students had received training in hand hygiene in past 3 yrs. Amongst the medical students 70.8%, dental 62% and nursing 42.3% received formal training in hand hygiene, this association was statistically significant as seen in Table I.

Table-I: Distribution of students according to

The medical and nursing students had very poor knowledge that unclean hands of health care workers can transmit harmful germs to patients, whereas dental students had better knowledge about the same and the difference was statistically significant. as shown in Table II.

But when it came to actions for preventing

Regarding use of alcohol-based hand rub medical students had better knowledge regarding time required to kill most germs as compared to dental and nursing students and this difference was statistically significant. Knowledge regarding washing of hands after exposure to blood was better

In a study done in Iran 16.4% participants, in Ghana study 77.3% participants received training in hand hygiene, whereas in our study 58% participants were trained in hand hygiene [8,9]. Study done at Mumbai 14.2% medical, 14.8% dental and 95% nursing students received formal training in hand hygiene, in our study 70.8% medical, 62% dental and 42.3% nursing students received training in hand hygiene [10].

In the study done in Bhopal no significant difference in knowledge among the participants about the route of transmission of germs, but in our study dental students had better knowledge as compared to medical and nursing students and the difference was statistically significant [11]. The most frequent source of germs responsible for health care-associated infections are the germs already present on or within the patient. This answer was given correctly by 23.6% students in the Gulbarga study, whereas in our study only 10% students gave correct answer [12].

Medical and nursing students had better knowledge as compared to dental students regarding hand hygiene actions which prevent transmission of germs to the patient and this difference was statistically significant.

The knowledge about hand hygiene was not satisfactory among the students. Formal training was received by some students only. Hand hygiene is very important for prevention of infections from the healthcare personnel to the patients and vice versa. Hand hygiene training can be made mandatory for medical, dental and nursing students as they handle patients. Hand hygiene can also be included in the curriculum so that its importance is emphasized on the students.

Impact of the current study: The current study has added to the available evidence that knowledge about hand hygiene is not satisfactory among the medical, dental and nursing students who are health care professionals responsible for spreading infections to the patients. This evidence can be used in designing curriculums to include hand hygiene and make it mandatory so that the students practice it and will help in reducing infections.

• Chaitali Gore: Involved in designing the study, data analysis, manuscript writing and review
• Bindu M: Involved in designing the study, data collection, data analysis, manuscript writing
• Lubdha Saxena: Involved in designing the study, data collection, data analysis, manuscript writing

Authors would like to thank the management of Vydehi Institute of Medical Science and Research Centre for all the facilities provided for this study. We would also like to thank Preethi G, Srujana. A and Dhanya Rafi for their help in conducting the study.