Assessment of Hand Hygiene Compliance and Its Relationship to Nosocomial Infections at Ekiti State University Teaching Hospital

Hand hygiene is the single most effective measure for preventing healthcare-associated infections, yet compliance among healthcare workers remains suboptimal in many Nigerian hospitals. This observational study assessed hand hygiene compliance rates and their relationship to nosocomial infection incidence at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Ekiti State, in the South West geopolitical zone of Nigeria. A validated direct observation tool based on WHO five moments of hand hygiene was used by trained infection control observers to record 1,200 hand hygiene opportunities across four clinical wards over three months. Concurrently, the incidence of hospital-acquired infections was extracted from infection control registers for the same period. Overall hand hygiene compliance was 38.6 percent. Physicians had the lowest compliance rate at 26.1 percent, while midwives achieved the highest at 52.4 percent. Wards with the lowest compliance rates had the highest healthcare-associated infection incidence rates (r = -0.82, p < 0.01). Lack of readily accessible hand rub dispensers and inadequate supervisor feedback were the primary barriers identified. The study recommends installation of bedside alcohol-based hand rub dispensers, continuous staff feedback, and a hospital-wide hand hygiene campaign supported by senior leadership at EKSUTH. Keywords: hand hygiene, nosocomial infection, healthcare workers, Ekiti, infection control.