Factors associated with noncompliance to hand hygiene standards among nurses at one hospital in Windhoek, Namibia

Abstract

The purpose of this study was to describe factors associated with noncompliance to hand hygiene standards among nurses in one public hospital in Windhoek, Namibia. A quantitative, descriptive, cross-sectional research design was employed using a stratified sample comprising three categories of nurses (registered, enrolled and auxiliary nurses). Data collection was done using a structured questionnaire. Based on the results, there were more institutional than individual factors associated with noncompliance to hand hygiene. Compliance to hand hygiene was found to be lowest when nurses provide care for patients in non-isolation rooms, when the perceived risk of acquiring infection from patients was low and following brief encounters with patients. Dryness of the skin caused by hand hygiene agents and lack of active participation in hand hygiene promotion at individual level contributed to noncompliance to hand hygiene among nurses. In addition, the results showed that, institutionally there were no rewards/encouragement for hand hygiene, no sanctions for non-compliers and no workshops, seminars and continuing educational courses on hand hygiene. The study produced interesting insights into the vital role that good leadership plays in the implementation of hand hygiene policy guidelines. The key recommendations for this study included development of good leadership, characterized by dedication for hygiene standards to encourage staff to maintain hygiene practice and to ensure that there are adequate resources for the implementation of hand hygiene policy as well as rewards/incentives for compliers and sanctions for noncompliers