CROSS-SECTIONAL ASSESSMENT OF HAND HYGIENE PERFORMANCE AND HOSPITAL-ACQUIRED INFECTION RATES: A SINGLE-CENTRE STUDY

Abstract

Hospital-acquired infections (HAIs) remain a critical public health burden, contributing to increased morbidity, mortality, and healthcare costs. Hand hygiene (HH) is the cornerstone of infection prevention, yet compliance among healthcare workers (HCWs) is often suboptimal. Contemporary, concurrent assessments linking direct HH observation with real-time HAI rates are needed to validate this relationship in modern practice settings.

Objectives: This study aimed to: 1) Assess the overall and profession-specific HH compliance rates among HCWs in a tertiary hospital using direct observation, 2) Measure the point prevalence of key HAIs, and 3) Correlate unit-specific HH performance with corresponding HAI prevalence.

Methods: A hospital-wide cross-sectional assessment was carried out on a single day. Hand hygiene compliance was directly observed by trained staff following the WHO “My Five Moments for Hand Hygiene” approach. At the same time, the point prevalence of healthcare-associated infections was recorded, including ventilator-associated pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and surgical site infections. Standard CDC/NHSN definitions were used for case identification. The collected data were summarized using descriptive statistics, and the association between variables was examined using Spearman’s rank correlation test.

Results: Overall HH compliance was 78.4% (1256/1602 observed moments). Compliance varied significantly by HCW profession: physicians 71.2%, nurses 82.1%, and ancillary staff 68.5%. The hospital-wide HAI point prevalence was 8.7% (89/1023 inpatients). A significant inverse correlation was found between ward-level HH compliance and HAI prevalence (r_s = -0.72, p=0.008).

Conclusion: Overall hand hygiene compliance was good; however, noticeable differences were seen between professional groups. Wards with better compliance tended to report fewer healthcare-associated infections, underscoring the importance of hand hygiene in routine patient care. There is a clear need for focused efforts to support and improve compliance among groups where performance remains suboptimal.