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This study investigated the actual conditions of hand hygiene after diaper exchange conducted by staŠ working in special elderly nursing homes, and discusses hand hygiene education. A survey based on observation research and self-administered questionnaires was conducted targeting 115 staŠ working in four special elderly nursing homes. According to observation research, only 3.5 of the subjects performed correct hand hygiene. In contrast, the Health, Labour and Welfare Ministry study ``Research on How Infection-control in Elderly Nursing Institutes should be'' found the hand-washing implementation rate after diaper-changing was 64.3, and alcohol-based hand-ˆnger disinfection rate was 73.4. However, the glove-wearing rate was 100, which was considered to be a substitution for hand hygiene. According to the self-administered questionnaire, 90.1 of the subjects performed hand hygiene. These ˆndings emphasize the diŠerence between subject awareness and actual behavior, and had similar results for appropriate timing of exchanging gloves. Therefore, any survey concerning hand hygiene should be based on observation. Hand-ˆnger education in special elderly homes must emphasize the necessity of hand washing with the knowledge of the characteristic, of gloves, and practical work methods to achieve hand hygiene, and appropriate timing for exchanging gloves. Key wordsspecial elderly nursing home, hand hygiene, glove-wearing, infection control

Actual Conditions of Hand Hygiene after Diaper-Changing in Special Elderly Nursing Homes Using the Direct Observation Method-First Report