Predictors of compliance with recommended hand hygiene practices among healthcare workers in specialist hospitals of Kano, Northwest Nigeria

Abstract

Background: Compliance with recommended hand hygiene practice among healthcare providers is important in the prevention of morbidity and mortality associated with hospital acquired infections including drug resistant microorganisms.

Objective: This study determined the predictors of compliance with recommended hand hygiene practices among healthcare workers in specialist hospitals of Kano metropolis, Northwest Nigeria.

Method: World Health Organization recommended observation checklist for hand hygiene compliance and Key Informant Interviews involving members of Infection Prevention and Control teams of the two selected hospitals were used to collect data using two staged and purposive sampling techniques respectively. Quantitative data from the observation checklist was analyzed at univariate, bivariate and multivariate levels using SPSS version 22 while verbatim transcripts from qualitative interviews were analyzed using thematic framework analysis.

Results: The overall compliance with hand hygiene was (42.4%). Use of alcohol based hand rub and soap and water constituted (26.7%) and (15.7%) respectively. Statistically significant association was found between type of the ward (P<0.001), Professional cadre (P<0.001), indication for hand hygiene (P<0.001), time of the day (P<0.05) and compliance with hand hygiene. Key Informant Interviews revealed lack of materials needed for hand hygiene to be associated with non-compliance. Working in medical ward and being a doctor were associated with 86% increased likelihood of compliance with recommended hand hygiene practice {AOR=0.14, 95% CI= (0.0-.4)}.Similarly, contact with patients’ surrounding/environment was associated with four fold increased likelihood of compliance with hand hygiene { AOR= 3.7, 95% CI= ( 2.7-5.0)}, further, evening and night shifts were associated with 2 folds increased likelihood of compliance with hand hygiene than morning shift { AOR=2.0, 95% CI=(1.0-3.7)}.

Conclusion: Compliance with recommended hand hygiene practices was not encouraging and may pose significant risk of hospital acquired infection. Therefore, Hospital management should ensure the existence of functional infection prevention and control team, regular training and re-training of healthcare workers.