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Predictors of compliance with the ‘five key moments' for hand hygiene among healthcare providers in public healthcare settings in south-south Nigeria

Background : Despite the well-recognized role of hand hygiene in the prevention of healthcare associated infections, the rate of compliance with hand hygiene among healthcare providers remains poor in Nigeria. Objective : To assess the predictors of compliance with hand hygiene among healthcare providers in south-south Nigeria. Methods: A cross-sectional study design with prospective covert observation of compliance with hand hygiene was employed to assess the hand hygiene compliance among 565 healthcare providers. Data was collected using a self-administered semi-structured questionnaire and an observation checklist. Descriptive and inferential analyses of data collected were carried out using the IBM SPSS version 22 software. Results: The covertly observed and self-reported compliance rates were 18.6% and 16.9% respectively. The rates of compliance with hand hygiene observed for ‘after blood and body fluids exposure’ (50.7 %) and ‘before aseptic procedures’ (30.7%) were relatively higher than compliance rates observed for the other moments for hand hygiene. Adequate knowledge of hand hygiene (AOR = 2.70; 95% CI: 1.60 – 4.58), in-service training on IPC (AOR = 2.31; 95% CI: 1.45 – 3.67) and good perception of the risk of acquiring HCAIs (AOR = 1.69; 95% CI: 1.04 - 2.77) were predictors of compliance with hand hygiene. Conclusion: The study brings to the fore the low rates of covertly observed and self-reported compliance with hand hygiene among the study participants. There is need for the management of the selected health facilities to stimulate and motivate healthcare providers to improve their compliance with hand hygiene.