Barriers to Effective Hand Hygiene Compliance Among Nurses in Hospital Settings

Abstract

Hand hygiene is one of the most effective and affordable measures to prevent healthcare-associated infections (HAIs). Despite its recognized importance, adherence among nurses remains suboptimal due to various individual and institutional barriers. Understanding these barriers is crucial to improve compliance and promote patient safety in hospital settings. This study aimed to explore the individual and institutional barriers that hinder effective hand hygiene compliance among nurses working in public hospitals. A qualitative research design was adopted using an interpretivist approach. Data were collected through semi-structured interviews with nine nurses working in different departments of two public hospitals. Thematic analysis was applied to identify recurring themes and patterns related to hand hygiene barriers. Two major themes emerged from the data: Individual Barriers and Institutional Barriers. Individual barriers included lack of continuous education and training, overconfidence, perceived low risk of infection, forgetfulness, influence of others, and skin irritation. Institutional barriers comprised lack of resources, heavy workload, inconvenient sink locations, and reliance on gloves as a substitute for handwashing. The findings indicated that inadequate infrastructure and insufficient institutional support significantly reduce nurses’ compliance with hand hygiene practices, despite their awareness of its importance. Both individual and institutional factors contribute to poor hand hygiene compliance among nurses. Addressing these barriers through education, adequate resource provision, workload management, and leadership support is vital to enhance compliance and reduce healthcare-associated infections.