Hand hygiene practices and compliance among healthcare workers in Maruzi health sub district, Apac district
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Introduction:Hand hygiene has been found to be the most effective methods of preventing healthcare associated infections.This study sought to assess factors influencing hand hygiene practices and compliance among healthcare workers in health facilities in Maruzi health sub-district, Apac district. Methodology:This was a cross-sectional study employing both qualitative and quantitative methods. Structured questionnaire and observational checklist were used to collect quantitative data, while key informants interview guide to collect qualitative data.A total of 190 trained healthcare workers and 16 key informants were interviewed. Quantitative data was analyzed using SPSS version 23.0 where, analyses were performed at univariate, bivariate and multivariate levels. Qualitative data was analyzed manually by organizing into major themes and reported in verbatim. Results: Analysis of respondent’s characteristics showed that majority, 60.0% (114/190) were females, half 50.0% (95/190) were diploma holders and 64.7% (123/190) were nurses. The most available type of hand hygiene facility was sink 42.6% (52/122) and least being alcohol based hand rub 16.4% (20/122). Midwives had the highest proportion 65.0% (13/20) of providers, practicing hand washing with soap whereas; doctors registered the highest proportion 42.9% (3/7) of users of alcohol based hand rub. The most utilized moment of hand hygiene was before patient 36.3% (69/190). After adjustments, key factors found to be positively associated with hand hygiene compliance were; staff training (OR=2.11, 95% CI: 1.31-4.97), supervision/coaching (OR=5.45, 95% CI: 1.30-9.01), and knowledge (OR=3.06, 95% CI: 1.48-19.69). Qualitative analysis revealed poor attitude of healthcare workers towards hand hygiene, trainings and supervision were found to be important factors for hand hygiene compliance. Conclusions: This study revealed low hand hygiene compliance rate (16.3%) across all healthcare workers. Compliance was highest among laboratory personnel (27.3%) than other cadres and analysis of the 5 key moments of hand hygiene showed highest compliance rate before touching patient (36.3%). Sinks were most used hand hygiene facility (42.6%) as compared to alcohol-based hand rub (16.4%). Key factors found to have influence on hand hygiene compliance were; staff training, supervision/coaching, knowledge, before aseptic xiv procedure and after patient’s contact. However, it is important for District Health Office to put in functional infection Prevention and Control Committees in all health facilities.