HAND HYGIENE PRACTICE AND ASSOCIATED FACTORS AMONG NURSES IN GOVERNMENTAL HOSPITALS OF HARARI REGIONAL STATE, EASTERN ETHIOPIA

Abstract

Introduction: Healthcare workers’ hands are the most common vehicle for the transmission of healthcare-associated pathogens from patient to patient and within the healthcare environment. Hand hygiene is the leading measure for preventing the spread of antimicrobial resistance and reducing healthcare-associated infections (HCAIs), but healthcare worker practices on hand hygiene remains low in most settings. Previous studies in Ethiopia focus on general health care workers. This study assessed hand hygiene practice and influencing factors among nurses in governmental hospitals who make the majority and providing care to the patients 24 hours. Objective: To assess Hand hygiene practice and associated factors among Nurses in governmental hospitals of Harari regional state in Eastern Ethiopia from January 25 –February 20/2017. Methodology: Hospital based cross-sectional was applied to assess 388 nurses selected from governmental hospitals of Harari regional state. Data were collected by self-administered questionnaire and Ward infrastructure survey by 4th year nursing students. The collected data were entered into Epi Data 3.1 and then exported and analyzed using SPSS 22. Bivariate and multivariate logistic regression models were used to identify factors associated with the self reported practice of hand hygiene. Then information’s were presented by using frequencies, summary measures, tables and graphs. A total of 369 study participants xii were interviewed that gave a response rate of 95.1%. The self reported practice was found to be 63.1%. Being male [(AOR=2.04, 95% CI: (1.21, 3.45)], participated in training [AOR=3.38 95% CI: (1.83, 8.04)], hospitals where sink conveniently located [AOR=2.74 95% CI: (1.61, 4.65)] and nurses who did not wear glove [AOR=2.03 95% CI: (1.20, 3.43)] working in medical ward [(AOR=0.34, 95% CI: (0.14, 0.79)], Surgical ward [(AOR=0.37, 95% CI: (0.16, 0.90)] and Intensive care unit (ICU) [(AOR=0.30, 95% CI: (0.09, 0.97)] and fear irritation and dryness to hand washing agent [AOR=0.26 95% CI: (0.15, 0.44)] were factors significantly associated with hand hygiene practice. Conclusion and recommendation: Even though the self reported practice was good. Factors associated with hand hygiene practice were absence of resources, inconvenient infrastructure, poor awareness may be due to lack specific training, effect of detergents on the skin and the assertion that nurses believe wearing gloves is a substitute for hand hygiene practices. Therefore, training and educating nurses, monitoring compliance and providing feedback, and embedding the practice of hand hygiene in the institutional safety culture and patient engagement should be considered to increase the practice of hand hygiene.