Barriers to Hand Hygiene Compliance Among Nurses at DHQ Hospital Charsadda

Abstract

Background: Hand hygiene is a cornerstone of infection prevention, yet compliance among healthcare workers remains suboptimal in many low-resource settings. Nurses, as the largest group of frontline providers, are particularly influential in the transmission or prevention of healthcare-associated infections. Objective: To identify predominant barriers to hand hygiene and describe knowledge and practice among nurses at District Headquarters (DHQ) Hospital Charsadda. Methods: A descriptive cross-sectional study was conducted among 50 registered nurses using a structured, self-administered questionnaire and a brief observation checklist based on World Health Organization guidance. Data on demographics, knowledge, self-reported practice, perceived barriers, and observed behaviour were analysed using descriptive statistics in SPSS version 26. Results: Most nurses were older than 30 years and highly experienced, with 64% reporting more than 10 years of service. Only 36% correctly identified the WHO-recommended 40–60 seconds handwashing duration, and recognition of all WHO “key moments” was rare. While 56% reported frequently washing hands before patient contact, only 10% always wore gloves; 58% used reusable cloth towels for drying. Observations showed pre-contact hand hygiene in 76% of encounters and glove use in 44%. The principal barriers were lack of handwashing facilities (52%) and insufficient hand sanitiser (34%). Conclusion: Structural constraints, particularly inadequate infrastructure and supplies, coexist with knowledge and practice gaps and likely undermine effective hand hygiene among nurses at DHQ Hospital Charsadda.