Evaluating the Compliance of Hand Hygiene Intervention Among Healthcare Workers in Mitigating Healthcare-Associated Infections in Cancer Patients

Abstract

Background: Immunocompromised cancer patients are highly susceptible to hospital-acquired infections (HAIs), making hand hygiene (HH) a critical intervention for infection prevention. This study evaluates the effectiveness of a multimodal HH program in a tertiary care oncology hospital in Mumbai, western India

Methods: A prospective pre-post interventional study was conducted from January 2023 to December 2024. The study involved 150 healthcare workers (HCWs) across oncology wards, hematopoietic stem cell transplantation units, and intensive care units, with 12,500 HH opportunities observed. The intervention included infrastructure improvements (alcohol-based hand rub dispensers), monthly training on WHO’s “Five Moments for Hand Hygiene,” real-time feedback, workplace reminders, and leadership engagement. HH compliance (total, partial, and complete) was assessed using WHO observation forms, and HAI incidence was monitored as per CDC criteria. Data were analysed using chi-square tests (p<0.05).
Results: Pre-intervention HH compliance was 48.2% (total), 32.1% (partial), and 16.1% (complete), improving post-intervention to 72.5%, 48.7%, and 23.8%, respectively (all p<0.01). Nurses showed the highest compliance (76.4% post-intervention). HAI incidence decreased by 28%, from 15.4 to 11.1 per 1,000 patient-days (p<0.05), with a 35% reduction in neutropenic patients (p<0.01). Bloodstream infections and pneumonia saw the most significant declines.

Conclusion: The multimodal HH intervention significantly improved compliance and reduced HAIs among immunocompromised cancer patients, demonstrating its value in resource-limited settings. Sustained training and infrastructure support are crucial for maintaining these gains.