لخّصلي

Nurses should be extremely diligent with handwashing
as they are often exposed to many
biohazards[2]. Our study included 28 nurses working at
the NICU,with an average age of 28.7 years. Though
this work revealed that age is an insignificant factor for
compliance with proper hand-washing. Other studies
have concluded otherwise. A study in Philippines, for
instance, evaluated 58 student nurses on their
knowledge and degree of compliance regarding
standard precautions in a government university, and
found that younger nurses were able to acquire
knowledge and improve behaviors for keeping up-todate
on these precautions [13]. Another study found that
the level of knowledge of 152 physicians and 227
nurses on blood-borne infections in two randomly
selected health regions in Kuwait was poorer in older
participants [14].
The percentage score of the availability of
hand-hygiene equipment and supplies in the NICU
under study was 73.6%.This is consistent with other
studies that concluded that hand-washing facilities in
developing countries were suboptimal; a lack of
sufficient sinks and running water is not uncommon
[15].The current study illustrates that all participants
washed their hands with the standard materials before
initiating contact with patients, before manipulating
medical devices or handling wound dressing, and after
using the bathroom, toilet, or latrine. On the other hand,
only 39.3% washed their hands after touching
potentially contaminated objects or surfaces, 21.4 %
after removing their gloves, and 17.9% after contact
with patients or their surrounding environments. These
figures are lower than those declared by Lawal et al.
(2018),who studied 113 nurses in a federal medical
center in Nigeria and found that 68.8% of subjects
washed their hands before contact with patients, and
nearly all of them (99%) washed their hands after
interacting with patients and after removing their gloves
[16].
Moreover, a study in Kano investigatedthe
situations of hand-washing among 137 medical and
nursing students. Their findings revealed that 72
students (52.6%) washed their hands before interacting
with patients, but the majority (94.9%) washed their
hands afterwards[17].The study by Labrague et al. found
that 65.5% of their studied sample usually complied
with washing their hands before interacting with
patients, and most (93.1%) washed their hands
immediately after dealing with any blood, bodily fluid,
secretion, excretion, or waste substances [13] .The
majority of nurses always washed their hands after each
patient contact rather than before. This selective
implementation could be explained by nurses wanting
to protect themselves more than protecting their
patients. This suggests that nurses prioritize their own
safety over their patients’ safety [18].
Our results were similar to those of Sharma et
al. who evaluated hand-washing behaviors among
healthcare workers in Chandigarh Teaching Hospital
and found a low baseline rate of hand-washing
adherence in the NICUs [19].Regarding hand-hygiene
practices, the present work showed that the mean
assessment score among the studied sample was
7.1±1.2 and the mean percentage score was 64.2±11.3.
This agrees with the results of a study conducted in 10
wards in AinShams University Hospital that found the
practice of appropriate hand-washing technique in
76.3% of their sample [11].
With respect to the rating of nurses’ handwashing
behaviors, 7.1% followed the recommended
practices consistently, while 75% usually complied
with the recommended practices, and 17.9% required
training and follow-up on these practices. This
corroborates the findings of Erasmus et al. (2010), who
stated that, despite clear guidelines and monitoring,
hand-hygiene adherence of nurses in healthcare
organizations remains unsatisfactory [20]. Additionally,
163 physicians were investigated by Pittet et al. who
studied hand-hygiene practices during routine patient
care and found a 57% adherence rate [3]. Moreover, the
research conducted by O’Boyle et al. stated that nurses
were unaware of their poor hand-washing practices
given that the self-reported rates and the observed rates
were vastly different [21].This low adherence to proper
hand-washing practices may be due to the lack of
adequate equipment and supplies, absence of
appropriate infrastructure, lack of support for a handwashing
program (e.g., low priority for an organization,
lack of active participation, lack of role models), and
conflict between the need to provide care and the
instinct for self-safety.
This study revealed a statistically significant
difference between nurses in class A, class B, and class
C regarding hand-washing practices and nursing
program attended. The practices were better among
nurses who graduated from the Faculty of Nursing
compared to those from either the Technical Institute of
Nursing or the Nursing School. This conflicts with the
results of Binbach et al. who found that even when
medical students receive intensive hand hygiene
education, compliance remains low; therefore, the
completion of annual safety courses is encouraged [22].
This bolsters our finding that a lack of training courses