Assessment of Hand Hygiene Compliance Among Healthcare Workers in a Tertiary Care Hospital: An Observational Study Based on WHO Five Moments

Background Hand hygiene is widely recognized as the most effective and economical intervention for preventing healthcareassociated infections (HAIs). Despite well-established guidelines, adherence to hand hygiene practices among healthcare workers remains inconsistent across healthcare settings worldwide. Suboptimal compliance contributes to the transmission of pathogens within hospitals, increasing patient morbidity, mortality, and healthcare costs. Monitoring hand hygiene practices using standardized frameworks such as the World Health Organization (WHO) "Five Moments for Hand Hygiene" is essential for identifying gaps in compliance and improving infection prevention strategies. Aim To assess the level of hand hygiene compliance among healthcare workers and to compare adherence patterns among different professional groups in a tertiary care hospital. Methods This cross-sectional observational study was conducted among doctors, nurses, and interns working in various wards of a tertiary care hospital. Hand hygiene opportunities were observed directly using the WHO "Five Moments for Hand Hygiene" framework. Compliance was recorded during routine patient care without prior notification to minimize observer bias. Data were analyzed to determine overall compliance rates and to compare adherence across professional groups and clinical indications. Results A total number of hand hygiene opportunities were observed across different healthcare workers and clinical settings. Overall compliance was moderate, with nurses demonstrating higher adherence compared with doctors and interns. Compliance was higher after patient contact and exposure to body fluids, whereas significantly lower adherence was observed before patient contact and before aseptic procedures. Variations in compliance were also observed across clinical departments. Discussion The findings demonstrate that although awareness of hand hygiene exists among healthcare workers, actual adherence remains inconsistent. Targeted training programs, periodic monitoring, and institutional reinforcement of infection prevention protocols are necessary to improve compliance. Strengthening hand hygiene practices is critical to reducing healthcare-associated infections and improving patient safety in hospital settings.