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. 2023 Sep:139:220-227.
doi: 10.1016/j.jhin.2023.07.012. Epub 2023 Jul 27.

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

M G D Harun  1 , M M U Anwar  2 , S A Sumon  3 , T M Mohona  3 , M Z Hassan  3 , A Rahman  4 , S A H M Abdullah  5 , M S Islam  6 , L P Oakley  7 , P Malpiedi  7 , S C Kaydos-Daniels  8 , A R Styczynski  7
Affiliations

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

M G D Harun et al. J Hosp Infect. 2023 Sep.

Abstract

Background: Hand hygiene (HH) is a fundamental element of patient safety. Adherence to HH among healthcare workers (HCWs) varies greatly depending on a range of factors, including risk perceptions, institutional culture, auditing mechanisms, and availability of HH supplies.

Aims: This study aimed to evaluate HH compliance and associated factors among HCWs in selected tertiary-care hospitals in Bangladesh.

Methods: During September 2020 to May 2021, we conducted non-participatory observations at 10 tertiary-care hospitals using the WHO's '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.

Results: 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 (adjusted odds ratio: 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.

Conclusions: HH compliance among HCWs fell significantly short of the standard for safe patient care. Inadequate HH supplies demonstrate a lack of prioritizing, promoting and investing in infection prevention and control.

Keywords: Bangladesh; Hand hygiene; Healthcare workers; Healthcare-associated infection; Resource-constrained settings.

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Conflict of interest statement

Conflict of interest statement

The authors have no competing interests to disclose.

Comment in

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