Abstract: OBJECTIVE To understand the health care workers' awareness of hand hygiene and safe injection in 90 medical institutions of Tianjin by conducting questionnaire survey so as to better promote and implement the ideas and standards for hand hygiene and safe injection and achieve continuous improvement. METHODS By means of self-designed "hand hygiene and safety injection test", totally 9777 questionnaires were recycled through network link or WeChat scan from Apr 2018 to Jun 2018, all of the questionnaires were reviewed and scored so as to determine the health care workers' awareness of the hand hygiene and safe injection in the medical institutions, and the statistical analysis was performed with the use of SPSS 17.0 software. RESULTS Three was significant difference in the score among the health care workers (F=16.977,P＜0.001), the score of the medical technicians was the highest; the scores of the health care workers were significantly higher in the tertiary medical institutions than in the secondary an primary medical institutions (F=6.547,P=0.001); the scores of the health care workers were significantly higher in the medical institutions of 6 urban districts than in the medical institutions of suburban counties (t=36.546,P＜0.001). CONCLUSION It is necessary to strengthen the theoretical training for hand hygiene and sage injection of the health care workers of the suburban medical institutions, carry out effective assessment and raise the awareness of the health care workers in non-tertiary or suburban medical institutions so as to reduce the incidence of occupational exposure.