Background: Hand hygiene (HH) is an effective strategy to prevent infections. This study aimed to explore the association between HH behavior among peritoneal dialysis (PD) patients or caregivers and PD-related infection.

Method: A single-center, cross-sectional study was conducted among PD patients and primary caregivers of totally-dependent PD patients. Data were collected through a participant information form and three different questionnaires about knowledge of HH, facilities for HH, and HH behavior. Documentation of PD-related infections were obtained from patients’ medical records during the last 12 months. Descriptive statistics and binary logistic regression were used to analyze the data.

Results: A total of 254 participants, including 181 PD patients (71%) and 73 caregivers (29%), were studied. The overall mean score for HH behavior was at a ‘good’ level (3.7 ± 0.3). Nearly half of the participants (46%) had a PD-related infection. In the binary logistic regression analysis, ‘improper’ hand and fingernail hygiene (OR 1.72, 95% CI: 1.04-2.84), ‘improper’ hand-washing steps (OR 1.68, 95% CI: 1.02-2.80), and ‘improper’ hand-washing during PD procedures (OR 2.32, 95% CI: 1.20-4.50) were significantly associated with PD-related infection.

Conclusion: ‘Improper’ HH behavior is associated with increased risk of PD-related infection. Our findings serve as input to develop efficient training and retraining programs for Thai PD patients and primary caregivers to improve their HH behavior and reduce risks of PD-related infection. Further investigation of training and retraining programs and of hand-washing techniques for PD is warranted.

Keywords: Hand hygiene behavior, Peritoneal dialysis, Peritoneal dialysis-related infections