An Appraisal of Nurses' Adherence to Hand Hygiene Protocols in Secondary Healthcare Facilities in Adamawa State
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Background of the Study
Hand hygiene is a fundamental component of infection prevention and control (IPC) in healthcare settings. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) emphasize that proper hand hygiene significantly reduces healthcare-associated infections (HAIs), which are a major concern in patient safety (WHO, 2023). Despite well-established guidelines, adherence among healthcare workers, particularly nurses, remains suboptimal, leading to increased morbidity and mortality in hospitalized patients (Smith et al., 2024).
In Nigeria, secondary healthcare facilities serve as critical intermediaries between primary care and specialized tertiary hospitals. Nurses, being the primary caregivers, play a vital role in ensuring adherence to hand hygiene protocols. However, studies have highlighted a gap between knowledge and practice, often attributed to factors such as lack of resources, high patient workload, and inadequate monitoring mechanisms (Adebayo & Yusuf, 2023). In Adamawa State, where secondary healthcare facilities handle a significant proportion of the population's healthcare needs, inconsistent adherence to hand hygiene practices has been linked to rising rates of nosocomial infections (Ogunlade et al., 2024).
Behavioral and institutional barriers to compliance remain a critical concern. While training and awareness campaigns have improved theoretical knowledge, practical adherence is still hindered by negligence, improper infrastructure, and ineffective enforcement of policies (Chukwu et al., 2024). The impact of this non-compliance extends beyond patient outcomes, affecting healthcare costs, professional accountability, and institutional reputation.
Given the importance of hand hygiene in reducing HAIs and ensuring patient safety, it is imperative to assess the level of adherence among nurses in secondary healthcare facilities in Adamawa State. Understanding the factors influencing compliance can provide insights for policy recommendations and practical interventions that promote consistent hand hygiene practices.
Statement of the Problem
Despite the well-documented benefits of hand hygiene in preventing HAIs, adherence to protocols among nurses in secondary healthcare facilities in Adamawa State remains inconsistent. Previous studies indicate that while nurses possess adequate knowledge of hand hygiene, the translation into routine practice is often limited (Johnson et al., 2023). The implications of this lapse are severe, leading to increased infection rates, prolonged hospital stays, and higher healthcare costs (Eze et al., 2024).
Moreover, institutional factors such as inadequate availability of hand sanitizers, ineffective supervision, and high patient-nurse ratios further complicate adherence. Studies have shown that healthcare workers in resource-limited settings are more likely to neglect hand hygiene due to environmental and workload constraints (Ahmed & Bello, 2024). In Adamawa State, where healthcare infrastructure and regulatory oversight are still developing, these challenges are exacerbated, necessitating an in-depth appraisal of compliance levels among nurses.
To bridge this gap, this study aims to evaluate nurses’ adherence to hand hygiene protocols, identify key barriers, and propose evidence-based strategies to enhance compliance.
Objectives of the Study
1. To assess the level of adherence to hand hygiene protocols among nurses in secondary healthcare facilities in Adamawa State.
2. To identify factors influencing nurses’ compliance with hand hygiene practices.
3. To recommend strategies for improving hand hygiene adherence in secondary healthcare settings.
Research Questions
1. What is the level of adherence to hand hygiene protocols among nurses in secondary healthcare facilities in Adamawa State?
2. What are the factors influencing nurses’ compliance with hand hygiene practices?
3. What strategies can be implemented to improve hand hygiene adherence?
Research Hypotheses
1. Nurses in secondary healthcare facilities in Adamawa State do not adhere to hand hygiene protocols at an optimal level.
2. Institutional and behavioral factors significantly influence nurses’ compliance with hand hygiene practices.
3. Implementing targeted interventions can improve adherence to hand hygiene protocols.
Scope and Limitations of the Study
This study focuses on secondary healthcare facilities in Adamawa State, assessing nurses' compliance with hand hygiene protocols. The research is limited to evaluating hand hygiene adherence based on self-reports, observational data, and institutional policies. Limitations include potential bias in self-reported practices and challenges in obtaining comprehensive institutional records on infection rates.
Definition of Terms
• Hand Hygiene: Practices involving handwashing, use of alcohol-based sanitizers, and other hand-cleansing measures to prevent infection transmission.
• Healthcare-Associated Infections (HAIs): Infections acquired in healthcare settings that were not present at the time of admission.
• Secondary Healthcare Facilities: Hospitals that provide specialized medical care, often serving as referrals from primary care centers.
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