HAND HYGIENE AUDIT AMONG HEALTHCARE WORKERS IN THE UNIVERSITY OF BENIN TEACHING HOSPITAL (UBTH)
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Abstract
Hand hygiene is a key component of infection prevention and control (IPC) strategies, proven to significantly reduce healthcare-associated infections (HAIs) and improve patient safety. Despite this, compliance with hand hygiene protocols among healthcare workers
(HCWs) in many healthcare facilities remains suboptimal. This study assessed the knowledge, attitude, compliance, and determinants influencing hand hygiene practice among healthcare workers in the University of Benin Teaching Hospital (UBTH), Benin City, Edo State, Nigeria. MATERIALS AND METHODS: A descriptive cross-sectional study design was employed in this study. The sample size was calculated using Cochran’s formula for descriptive studies. A stratified random sampling technique was utilized for the study. Data were collected using a structured self- administered questionnaire adapted from WHO hand hygiene tools, the Hand Hygiene Belief Scale (HHBS), and WHO ward infrastructure checklist. Data were analyzed using IBM SPSS version 27.0. Descriptive statistics were presented as frequencies, means, and percentages, while inferential statistics including Chi-square test and binary logistic regression were used to determine associations, with statistical significance set at p < 0.05. RESULTS: A total of 460 respondents participated in the study, with a mean age of 31.9 ± 7.7 years; 247 (53.7%) were females and 213 (46.3%) males. Almost all participants (457 [99.3%]) were aware of hand hygiene, and 359 (78.0%) had received formal training within the previous three years. However, only 170 (37.0%) demonstrated good knowledge, while 290 (63.0%) had poor knowledge. A positive attitude toward hand hygiene was observed in 349 (75.9%) respondents, yet only 210 (45.7%) demonstrated satisfactory compliance with the WHO’s Five Moments for Hand Hygiene. Nurses (185 [40.2%]) recorded the highest compliance rates compared with other cadres. Marital status (p = 0.033), profession (p = 0.027), and monthly income (p = 0.024) were significantly associated with knowledge. Logistic regression showed that being unmarried (AOR = 2.32; 95% CI: 1.36-3.94; p = 0.002), female (AOR = 1.62; 95% CI: 1.05-2.51; p = 0.031), and of the nursing profession (AOR = 2.54; 95% CI: 1.17-5.53; p = 0.019) independently predicted good knowledge. Facility assessment revealed inadequate availability of alcohol-based hand rubs (62 [13.5%]), inconsistent running-water supply, and incomplete handwashing infrastructure in several
wards. CONCLUSION: About a third of the health workers demonstrated good knowledge of hand hygiene, with marital status and profession identified as significant predictors. Half exhibited a positive attitude, which was associated with female gender, single marital status, paramedical profession, and longer years of practice. Approximately two-thirds were compliant with hand
hygiene practices, with nurses showing the highest compliance rates. Awareness of guidelines, understanding the importance of hand hygiene, and belief in its role in preventing infections were key facilitators, while only a third of the wards had adequate infrastructure to support and sustain proper hand hygiene practices.
(HCWs) in many healthcare facilities remains suboptimal. This study assessed the knowledge, attitude, compliance, and determinants influencing hand hygiene practice among healthcare workers in the University of Benin Teaching Hospital (UBTH), Benin City, Edo State, Nigeria. MATERIALS AND METHODS: A descriptive cross-sectional study design was employed in this study. The sample size was calculated using Cochran’s formula for descriptive studies. A stratified random sampling technique was utilized for the study. Data were collected using a structured self- administered questionnaire adapted from WHO hand hygiene tools, the Hand Hygiene Belief Scale (HHBS), and WHO ward infrastructure checklist. Data were analyzed using IBM SPSS version 27.0. Descriptive statistics were presented as frequencies, means, and percentages, while inferential statistics including Chi-square test and binary logistic regression were used to determine associations, with statistical significance set at p < 0.05. RESULTS: A total of 460 respondents participated in the study, with a mean age of 31.9 ± 7.7 years; 247 (53.7%) were females and 213 (46.3%) males. Almost all participants (457 [99.3%]) were aware of hand hygiene, and 359 (78.0%) had received formal training within the previous three years. However, only 170 (37.0%) demonstrated good knowledge, while 290 (63.0%) had poor knowledge. A positive attitude toward hand hygiene was observed in 349 (75.9%) respondents, yet only 210 (45.7%) demonstrated satisfactory compliance with the WHO’s Five Moments for Hand Hygiene. Nurses (185 [40.2%]) recorded the highest compliance rates compared with other cadres. Marital status (p = 0.033), profession (p = 0.027), and monthly income (p = 0.024) were significantly associated with knowledge. Logistic regression showed that being unmarried (AOR = 2.32; 95% CI: 1.36-3.94; p = 0.002), female (AOR = 1.62; 95% CI: 1.05-2.51; p = 0.031), and of the nursing profession (AOR = 2.54; 95% CI: 1.17-5.53; p = 0.019) independently predicted good knowledge. Facility assessment revealed inadequate availability of alcohol-based hand rubs (62 [13.5%]), inconsistent running-water supply, and incomplete handwashing infrastructure in several
wards. CONCLUSION: About a third of the health workers demonstrated good knowledge of hand hygiene, with marital status and profession identified as significant predictors. Half exhibited a positive attitude, which was associated with female gender, single marital status, paramedical profession, and longer years of practice. Approximately two-thirds were compliant with hand
hygiene practices, with nurses showing the highest compliance rates. Awareness of guidelines, understanding the importance of hand hygiene, and belief in its role in preventing infections were key facilitators, while only a third of the wards had adequate infrastructure to support and sustain proper hand hygiene practices.
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