Hand hygiene practice compliance among healthcare workers in a tertiary healthcare hospital in Kathmandu, Nepal

Hand hygiene is a critical practice to prevent healthcare associated infections (HCAIs). However, compliance to it among healthcare workers is very low. The study aims to assess hand hygiene practices in various situations among the healthcare workers of different departments in a tertiary care hospital in Nepal. The study is a hospital-based cross-sectional observational study among 260 healthcare workers selected using the stratified Proportionate random sampling method. Healthcare workers eligible for the study were those in ward rounds, doing procedures, and having actual contact with the patients and their surroundings. Using a WHO-developed checklist, an observation technique was used to collect the hand hygiene practice data among the healthcare workers. A total of 1068 hand hygiene opportunities were observed among 260 healthcare workers. The overall hand hygiene compliance was 30%, and the compliance was observed differently among the healthcare workers, where compliance of hand hygiene for doctors, nurses, and paramedics were 37%, 35%, and 23%, respectively. The WHO "5 moments" for hand hygiene compliance, "after body fluid exposure," was found to be higher (83%), followed by "after touching the patients' surroundings" (79%), and only 11% compliance was found "before touching the patient." Hand hygiene procedures were missed by 36% of paramedics, 30% of doctors, and 20% of nurses. The study reflects the need to promote hand hygiene practices among healthcare workers to prevent HCAIs, as compliance with hand hygiene action was only 30%.