Hand Hygiene compliance and associated factors among healthcare workers in selected tertiary care hospitals in Bangladesh

• Published in: The Journal of hospital infection Vol. 139; pp. 220 - 227
• Main Authors: Harun, Md. Golam Dostogir, Anwar, Md Mahabub Ul, Sumon, Shariful Amin, Mohona, Tahrima Mohsin, Hassan, Md. Zakiul, Rahman, Aninda, Abdullah, Syed Abul Hassan Md, Islam, Md Saiful, Oakley, Lisa P., Malpiedi, Paul, Kaydos-Daniels, S. Cornelia, Styczynski, Ashley R.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-09-2023
• Subjects: Bangladesh; Cross Infection - prevention & control; Guideline Adherence; Hand Hygiene; Health Personnel; Healthcare Workers; Healthcare-Associated Infection; Humans; Infection Control; resource-constrained settings; Tertiary Care Centers; Bangladesh; HH; CDC; AOR; CI; Healthcare-Associated Infection; LMICs; ICDDRB; resource-constrained settings; HAI; Bangladesh; VIF; Healthcare Workers; ABHR; ERC; IRB; Hand Hygiene; HCW; IPC; WHO; Healthcare workers; Healthcare-associated infection; Resource-constrained settings; Hand hygiene
• ISSN: 0195-6701; 1532-2939; 1532-2939
• DOI: 10.1016/j.jhin.2023.07.012

Hand hygiene (HH) is a fundamental element of patient safety. Adherence to HH among healthcare workers (HCW) varies greatly depending on a range of factors, including risk perceptions, institutional culture, auditing mechanisms, and availability of HH supplies.
This study aims to evaluate HH compliance and associated factors among healthcare workers in selected tertiary care hospitals in Bangladesh.
During September 2020 to May 2021, we conducted non-participatory observations at 10 tertiary-care hospitals using WHO ‘5-moments for hand hygiene tool’ to record HH compliance among physicians, nurses, and cleaning staff. We also performed semi-structured interviews to determine the key barriers to complying with HH.
We observed 14,668 hand hygiene opportunities. The overall HH compliance was 25.3%, the highest among nurses (28.5%), and the lowest among cleaning staff (9.9%). HCWs in public hospitals had significantly higher odds of complying with HH practices than those in private hospitals (AOR: 1.73, 95%CI: 1.55-1.93). The odds of performing HH after touching a patient were 3.36 times higher compared with before touching a patient (95% CI: 2.90-3.90). The reported key barriers to performing HH were insufficient supplies (57.9%), skin reactions (26.3%), workload (26.3%), and lack of facilities (22.7%). Overall, observed HH supplies were available in 81.7% of wards for physicians and 95.1% of wards for nurses, however, no designated HH facilities were found for the cleaning staff.
HH compliance among HCWs fell significantly short of the standard for safe patient care. Inadequate HH supplies demonstrates a lack of prioritizing, promoting, and investing in infection prevention and control.