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Introduction Hand hygiene best practice compliance rates are low in acute care settings despite investment in strategies in the acute care setting to improve hand hygiene practice. Knowledge of local influences such as health professionals' views on current strategies and influential factors is required to develop effective and sustainable interventions. Methods A single-centre cross-sectional survey was conducted to identify the views of 300 randomly sampled acute care health professionals from a tertiary referral teaching hospital, on the factors that they believe influence hand hygiene practice, and their views on strategies to improve compliance. Data were collected using a 19-question self-administered questionnaire and were analysed using descriptive statistics and chi-square tests to analyse differences between the clinical disciplines. Results The sample response rate was 39% (n = 118). Doctors were significantly less likely to report receiving hand hygiene education (p < 0.01) or familiarity with the five moments for hand hygiene (p < 0.01). Overall, respondents regarded organisational strategies more favourably than clinician or patient-focused strategies. Medical staff were less likely to agree with clinical area hand hygiene performance feedback (p = 0.03) while nursing staff were more likely to be agreeable to regular hand hygiene assessment (p = 0.02). Conclusion Hand hygiene education may require targeting of particular groups of health professionals to ensure that all clinical disciplines receive hand hygiene education. Hand hygiene strategies should be based on local needs and take into account contextual factors.

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