Hand Hygiene Awareness Research Articles

Reduced Incidence of Healthcare-associated Infections in a Long-term Care Facility by Converting to Automated Touchless Dispensing and Closed-refill Systems

Background Automated touchless dispensing and closed-refill systems minimize touch points that help prevent cross contamination events and reduce dispenser contamination with clinically significant pathogens in healthcare settings. Additionally, most consumers prefer touchless dispensing when using public restrooms. However, many healthcare settings still utilize manual dispensers for soap and sanitizer. Some even have open, bulk, refillable dispensing systems and manual pumps and dispensers. A finding of a clinical in-use study revealed a significant reduction in the incidence of healthcare associated infections (HAIs) following the conversion to automated touchless soap and sanitizer dispensing systems with premeasured dosage amounts in a long-term care (LTC) care facility. Methods A LTC facility was qualified as a testing site for clinical in-use study of hand hygiene (HH) products’ impact on healthcare workers’ (HCWs) hands. The facility replaced all HH manual dispensing systems and locally purchased hygiene products with automated touchless dispensers, closed-refill systems, and quality formulations. In addition to the biophysical measurements of HCWs hands using bioengineering instrumentation, the baseline incidence of HAIs was recorded prior to the intervention and surveillance continued from 2014 to 2018. HAI rates provided by the testing site were compared to the baseline data collected in 2014 with specific emphasis on the infection outbreak season from October to December in each year. Results Descriptive data analysis of HAI incidence rates revealed significant and sustained reduction in HAI rates from 6.7% in October through December of 2014 to 1.6 % the same period in 2015, 2.8 % in 2016 and 2.4 % in 2017. Conclusions Converting the HH framework from manual dispensing to automated touchless dispensing with closed refill systems during a clinical-in-use study resulted in a sustained reduction of HAI rates over a 3-year period. Increased awareness of HH, touchless hygienic dispensing systems, and HCW improved skin integrity are variables to consider for HAI reduction. Automated touchless dispensing and closed-refill systems minimize touch points that help prevent cross contamination events and reduce dispenser contamination with clinically significant pathogens in healthcare settings. Additionally, most consumers prefer touchless dispensing when using public restrooms. However, many healthcare settings still utilize manual dispensers for soap and sanitizer. Some even have open, bulk, refillable dispensing systems and manual pumps and dispensers. A finding of a clinical in-use study revealed a significant reduction in the incidence of healthcare associated infections (HAIs) following the conversion to automated touchless soap and sanitizer dispensing systems with premeasured dosage amounts in a long-term care (LTC) care facility. A LTC facility was qualified as a testing site for clinical in-use study of hand hygiene (HH) products’ impact on healthcare workers’ (HCWs) hands. The facility replaced all HH manual dispensing systems and locally purchased hygiene products with automated touchless dispensers, closed-refill systems, and quality formulations. In addition to the biophysical measurements of HCWs hands using bioengineering instrumentation, the baseline incidence of HAIs was recorded prior to the intervention and surveillance continued from 2014 to 2018. HAI rates provided by the testing site were compared to the baseline data collected in 2014 with specific emphasis on the infection outbreak season from October to December in each year. Descriptive data analysis of HAI incidence rates revealed significant and sustained reduction in HAI rates from 6.7% in October through December of 2014 to 1.6 % the same period in 2015, 2.8 % in 2016 and 2.4 % in 2017. Converting the HH framework from manual dispensing to automated touchless dispensing with closed refill systems during a clinical-in-use study resulted in a sustained reduction of HAI rates over a 3-year period. Increased awareness of HH, touchless hygienic dispensing systems, and HCW improved skin integrity are variables to consider for HAI reduction.

Impact of Hand Hygiene Simulation Driven by Neonatal Intensive Care Unit Multidisciplinary Team on Hospital Associated Methicillin-resistant Staphylococcus Aureus Screens

<h3>Background</h3> Hospital-associated infections (HAI) such as methicillin-resistant Staphylococcus aureus (MRSA) can have devastating consequences. The World Health Organization created the 5 moments for hand hygiene. It was identified in the neonatal intensive care unit (NICU) pod setting that health care workers did not always recognize opportunities due to workflow complexities. It was hypothesized that introducing hand hygiene simulations would increase hand hygiene awareness which would decrease prevalence of HAI MRSA screen positive NICU infants. <h3>Methods</h3> This was a pre/post study performed in a level 4 NICU with 54 beds from February 2018 through November 2019. Participants included 146 nurses, 30 physicians, 18 respiratory therapists, and 5 additional therapists. In January 2019, each discipline created a scenario which guided the participant through a clinical situation and monitored opportunities for hand hygiene. Simulations were carried out in empty pods in the NICU to closely mimic actual working conditions. MRSA screening was performed via nasal MRSA PCR or culture with testing of infants born outside the hospital on admission and routine testing of all infants every two weeks. The rate of MRSA-positive infants' pre-intervention and post-intervention was obtained, and a chi-squared test was utilized to compare the rates and determine statistical significance (p-value <.05). <h3>Results</h3> In the 11 months prior to the intervention, there were 13 infants with positive HAI MRSA screens across 11,010 patient days (1 per 847). In the subsequent 11 months, there were 6 infants with positive HAI MRSA screens across 12,191 patient days (1 per 2,032) When comparing these two rates, the p-value is 0.067. <h3>Conclusions</h3> We observed a decrease in the rate of infants with positive HAI MRSA screens following our introduction of hand hygiene simulations although that difference did not reach statistical significance. The fact that the scenarios were created by frontline care providers was one of the keys to success.

Impact of Pandemic COVID-19 on the knowledge and attitude of hand hygiene among medical graduates

Introduction: Hand hygiene is one of the most important measures among infection control practices. Knowledge of hand hygiene among medical graduates crucial in minimizing nosocomial infections. During the pandemic COVID-19, awareness is being created through various routes concerning hand hygiene to combat the pandemic. The current study targeted at determining the impact of awareness programs on hand hygiene awareness among medical graduates. Materials and Methods: This was a cross-sectional study based on a questionnaire to evaluate the knowledge of hand hygiene among second-year graduate medical students. The structured questionnaire was sent to the participants through the email and Whatsapp in the form of a google doc link. The degree of knowledge of hand hygiene was determined by dividing the responses into three classes based on a score of more than 75% considered good, 50-74% moderate, and 50% considered poor as less than. Individual responses received and the data analyzed. Results: A total of 95 students were included in the study. Out of these 54 (56.84%) were females and 41 (43.16%) males. A preponderance of knowledge level was found to be good (87%) among the participants. It has been observed that the majority of students had a positive attitude towards hand hygiene (98-100%). Conclusion: It was noticed from the results obtained in this study, that a significant rise in the knowledge levels and positive attitude among medical graduates during pandemic COVID-19.

A Quality Improvement Initiative to Increase Hand Hygiene Awareness and Compliance in a Neonatal Intensive Care Unit in Haiti.

Healthcare-associated infections (HCAI) are major causes of morbidity, mortality, increased lengths of stay and are an economic burden on healthcare systems in resources-limited settings. This is especially true for neonates, who are more susceptible with underdeveloped immune systems. Hand hygiene (HH) is a key weapon against HCAI, yet globally, HH compliance remains substandard. This study sought to determine the compliance with HH among healthcare workers (HCWs) in a children's hospital neonatal intensive care unit (NICU) in Haiti. A HH educational intervention was performed in the NICU, including lectures and posters. Pre- and post-intervention HH data were collected on HCWs and parents using the World Health Organization '5 Moments for HH'. Data were analyzed using standard statistical analysis. HH increased in all HCW roles but not in parents. Correct HH increased in all groups, including parents. HH was more likely to occur prior to patient contact than after patient contact. Correct HH was more likely to occur with alcohol-based hand rub than with soap and water. This study demonstrates that an inexpensive and simple intervention can significantly increase HH compliance in a resource-limited NICU, which may lead to decreased rates of hospital-acquired sepsis. Parents, however, due to cultural norms as well as literacy and language barriers, need targeted educational interventions distinct from those that HCW benefit from.

Antimicrobial resistance: the good, the bad, and the ugly.

As the Royal Society for Biology (RSB) was forming 10 years ago, antimicrobial resistance (AMR) was being heralded as the next threat with a magnitude on a par with global warming. Just a few years later, in 2016, Jim O'Neill's report was published laying out recommendations for tackling drug-resistant infections globally. Where are we now, and what are the challenges ahead? As a slow burner, how will the impact of AMR compare against the recent rapid devastation of the COVID-19 pandemic, and how can we channel some of the good things that come from it (like the awareness and technique of effective hand hygiene) to help us combat AMR speedily and definitively?

Compliance and Knowledge of Healthcare Workers Regarding Hand Hygiene and Use of Disinfectants: A Study Based in Karachi.

BackgroundHand hygiene is the cardinal step in combating various healthcare-associated infections. These infections are a cause of 37,000 deaths in Europe and 100,000 deaths in the United States annually. Thus, prevention of their spread is of utmost importance today. A study conducted in a tertiary care center in Karachi found that 17% of the medical professionals were aware of the World Health Organization (WHO) guidelines on hand hygiene while only 4.9% followed these hand-washing techniques. Lack of hand hygiene practice and awareness has raised a need to reassess infection control in hospitals. There is currently undisputed proof that adherence to hand cleanliness diminishes the danger of transmission of various infections.MethodsA questionnaire-based cross-sectional study was conducted at Dr. Ruth K.M. Pfau Civil Hospital, Karachi in January 2019. Data from 212 participants who met the inclusion criteria were analyzed. A three-part questionnaire was used for the hospital staff who had been present at the hospital for at least six hours and had attended to the patients during the last three continuous working days. Staff members who visited the hospital but did not attend to any patients or those who had been present at the hospital for less than six hours were excluded. Collected data were analyzed using Statistical Package for Social Science (SPSS) version 23.0 (IBM, Armonk, NY).ResultsA total of 212 individuals (74 doctors, 66 nurses, 52 technicians, and 20 ward assistants) agreed to participate in our study, of which 124 were females. The compliance with hand disinfectant use before and after every patient contact was found to be 12.3%. The use of disinfectant was found to be more among males than females (mean 7.88 times for males vs. 6.20 for females) and the younger individuals were more compliant with hand hygiene practices; 62.73% of participants were aware of the WHO guidelines regarding hand hygiene and 65.56% were aware of hospital-acquired infections. However, nearly half of the participants (45.75%) had never attended a formal lecture on the subject and more than half (62.26%) of the participants were unenlightened about the complications of hospital-acquired infections.ConclusionsHand hygiene is a basic requirement for every medic and paramedic in a hospital setting today. Keeping in mind the drastic consequences of the spread of hospital-associated infections, it is evident that hand hygiene should be stressed upon. The rising incidence of nosocomial infections and their complications can be prevented by raising awareness about hand hygiene practices. There is a need to further investigate the application of and adherence to the basic guidelines on hand hygiene. Our results indicate that this issue should be tackled through a multidimensional approach.

Wash and wipe to win over COVID-19

Background and Objectives: The COVID-19 is a serious issue in every corner of the globe affecting frontline warriors and other individuals. Appropriate hand hygiene measures are considered to be the most basic but effective steps to control this disease. The objective of the study was to assess the knowledge, awareness, and proper practice of hand hygiene among university undergraduate medical and nonmedical students. Materials and Methods: The present cross-sectional survey was conducted on 703 university undergraduate medical students (MBBS, BDS, BPT, nursing, and allied) and nonmedical students (engineering, law, commerce, etc.) at Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana, through the Google Forms by a prevalidated questionnaire to assess the knowledge and attitude regarding hand hygiene practices in this COVID-19 pandemic era. Results: The correct responses for questions based on recommended time of handwash (29.7%), minimum time required for alcohol-based hand rub to kill germs (70.1%), recommended concentration of hand rub (50.5%), and effective method of handwash (38.8%) were observed. Only 73% of the medical students and 58% of the nonmedical students knew exact steps of handwashing (as per the World Health Organization guidelines). Ninety-one percent of all the respondents agreed that they became more conscious about hand hygiene during COVID-19 pandemic. Eighty-two percent of the participants opined that the steps of hand hygiene must be included in routine curriculum. Conclusions: The results of the current survey presented an average score regarding hand hygiene knowledge and practices among university students for both medical and nonmedical streams in this COVID-19 pandemic era.

Standard Precautions for COVID-19: An Insight into the Awareness of Post Graduate Trainee Doctors Working At a Tertiary Level Dedicated COVID Hospital

Background: The rapid and extensive spread of the COVID-19 pandemic is a major concern for healthcare profession. Standard Precautions (SP) are the key to contain the spread. Adherence to existing SP is mostly user dependent and it is affected by their awareness. The Post Graduate (PG) trainee doctors are the immediate caregivers in a Dedicated COVID Hospital. The objective was to assess their awareness of SP , identify gaps in knowledge to help in future capacity building.&#x0D; Methodology: The cross sectional study was conducted in June 2020 at RNT Medical College, Udaipur, Rajasthan on 115 PG trainees from all streams. The questionnaire was adapted from standard COVID-19 Outbreak Guidelines from MoHFW , India and Centre for Disease Prevention and Control (CDC) Descriptive statistics were performed based on the percentage of correct answers.&#x0D; Results: Majority (54.8%) had only average awareness of SP . 62.6% displayed correct awareness of hand hygiene while it was much less for respiratory hygiene (12.2%),PPE donning16(13.9%)and doffing16(13.9%) and other elements of SP.&#x0D; Conclusions: Average and lesser awareness of SP elements among PG trainees is a matter of great concern, This indicates the need for frequent on going trainings on SP to be incorporated in the curriculum of the PG training program.

Factors influencing hand hygiene compliance of healthcare students

Hand hygiene is the most effective way to control healthcare-associated infections. The aim of this study is to measure the hand hygiene awareness and practices in relation to various variables among the healthcare students. A structured validated questionnaire was completed by the participants to assess their awareness and compliance with hand hygiene. The average knowledge score of 500 students was 6.24/10 with a significant difference between various departments (p = 0.001). Knowledge significantly increased by advanced years of study. The average attitude and practice scores were 6.96 and 5.13, respectively with significant differences only in practice between various departments but not within other variables. Despite an overall good knowledge and attitude, the compliance of hand hygiene was generally poor. These findings suggested that other factors than knowledge and attitude might play a role in compliance. Although there appears to be a direct correlation with knowledge and year of study (Correlation coefficient r = 0.96) a weaker correlation value was detected with attitude (r = 0.02). Conversely, we detected a negative correlation between compliance with hand hygiene and the year of study (r = -0.55). In contrast to many other studies, no gender difference in attitude and practice in this study.

Veterinarians’ Perception, Knowledge and Practices of Hand Hygiene in Enugu State Southeast, Nigeria

A cross-sectional survey utilizing questionnaire assessed veterinarians’ awareness, attitudes and practices of hand hygiene (HH) in Enugu State Southeastern Nigeria. Data obtained were analyzed using chi-square on SPSS (version 15.0) at a significance level of P &lt; 0.05 to determine possible associations between variables and perceptions/knowledge about HH. Out of 294 respondents, 26.9% were familiar with the WHO’s “5 moments of HH” model but majority knew the importance of the model. There was high compliance with HH after touching an animal (100%) and animal’s surrounding (96%), and contact with body fluid (100%) but HH before touching an animal (52.5%) and performing clean procedures (58.5%) were practiced sub-optimally. Majority of the respondents often forgets to perform HH (61.9%) and prioritizes clinical tasks to HH when busy (65%). The attitudes/practices towards HH were generally negative. Minority knew that unclean veterinary personnel’s hands are the main route of infection in the veterinary clinic (38.1%) and alcohol-based hand rubs are more effective on pathogens than other cleansing agents (23.1%). Majority of the respondents does not know when different HH techniques ought to be performed. The overall knowledge of HH by the respondents was moderate (55.4%). No significant association (P &gt; 0.05) was found between level of knowledge and gender, age, qualification, duration of practice and location. Poor knowledge of HH guidelines, unavailability and inaccessibility of HH facilities, and unavailability of reminders were the major barriers to compliance with appropriate HH practices. In conclusion, veterinarians’ awareness and perception about HH in the study area is moderate while the practices are sub-optimal, thus the education of Nigerian veterinarians about HH and the teaching of the principles and practices of appropriate HH during veterinary schools are recommended.

Hand-Hygiene awareness and Compliance from a tertiary care teaching hospital, Kolhapur

Hand-Hygiene awareness and Compliance from a tertiary care teaching hospital, Kolhapur

Hand Hygiene Awareness of the Middle School Students and Use of Theater Performance

Present study has been conducted to investigate the effects of raising the awareness of middle-school students toward hand hygiene via using theater performances. The population of this intervention study consists of 5th and 6th graders studying at the Middle-school. Prior to using the theater performance, 15.7% of students practiced proper hand-washing technique while after the theater, the ratios escalated to 33.8%. After the intervention, there was a statistically significant increase in the ratio of respondents having emphasized the need to wash hands as shown by the demonstrated technique(p&amp;lt;0.05). İt was demonstrated that upon performing drama, entertainment and didactic scenarios integrated theater activities among middle-school students, there was a heightened level of hand-hygiene awareness toward a manifold of issues in the short term. In addition it was detected that by teaching the proper technique students achieved to double increase their knowledge on hand hygiene.

Assessing the effectiveness of structured teaching on knowledge of hand hygiene among healthcare workers

Assessing the effectiveness of structured teaching on knowledge of hand hygiene among healthcare workers

Study of Hand Hygiene Awareness among Doctors and Nurses in King Abdulaziz Specialist Hospital

Background: hand hygiene is now regarded as one of the most important element of infection control activities. It is an effective strategy to prevent health care-associated infections (HCAIs). It is a required practice for all health care providers. It is done by using manually antibiotics jelly or washing hands by soap and tap water. Hand hygiene before and after examination of the patient is the first line of protection against infection as hand is considered the primary carrier of infections. Aim of the Work: was to assess the knowledge, attitudes and practice of doctors and nurses in King Abdulaziz Specialist Hospital. Patients and Methods: this descriptive cross-sectional study was conducted on the 110 of doctors and nurses in King Abdulaziz Specialist Hospital, who were interviewed between 3rd March 2017 and 9thApril 2017. Data were collected and analyzed using SPSS version 16. Results: out of 110 respondents, 57.3% were female and the nurses constituted the highest cadre (61.8%). Hand hygiene knowledge was highest in the Emergency Room (29.1%) and lowest among diabetes center staff (3.6%). Conclusion: hand hygiene is crucial for doctors and nurses and hence the need to improve their attitude, practice and knowledge. The presence of significant differences between doctors and nurses in our study indicated the need for qualified doctors who have enough information and knowledge about the importance of hand hygiene to assure control of infections as well as all hygienic affairs during working with patients enrolled in hospitals.

Study of Hand Hygiene Awareness among Doctors and Nurses in King Abdulaziz Specialist Hospital

Background: hand hygiene is now regarded as one of the most important element of infection control activities. It is an effective strategy to prevent health care-associated infections (HCAIs). It is a required practice for all health care providers. It is done by using manually antibiotics jelly or washing hands by soap and tap water. Hand hygiene before and after examination of the patient is the first line of protection against infection as hand is considered the primary carrier of infections. Aim of the Work: was to assess the knowledge, attitudes and practice of doctors and nurses in King Abdulaziz Specialist Hospital. Patients and Methods: this descriptive cross-sectional study was conducted on the 110 of doctors and nurses in King Abdulaziz Specialist Hospital, who were interviewed between 3rd March 2017 and 9thApril 2017. Data were collected and analyzed using SPSS version 16. Results: out of 110 respondents, 57.3% were female and the nurses constituted the highest cadre (61.8%). Hand hygiene knowledge was highest in the Emergency Room (29.1%) and lowest among diabetes center staff (3.6%). Conclusion: hand hygiene is crucial for doctors and nurses and hence the need to improve their attitude, practice and knowledge. The presence of significant differences between doctors and nurses in our study indicated the need for qualified doctors who have enough information and knowledge about the importance of hand hygiene to assure control of infections as well as all hygienic affairs during working with patients enrolled in hospitals.

Assessment of personal protective equipment use and occupational exposures in small industries in Jeddah: Health implications for workers.

Small-scale industries account for a large proportion of jobs and play a vital role in most countries’ economic growth and prosperity. Due to the very low use of personal protective equipment (PPEs), employees are exposed to numerous physical, chemical, and accidental hazards in small-scale industries. PPEs are very effective in minimizing occupational injuries, accidents, and other hazards which otherwise result in substantial manpower and financial losses. The study objective was to assess the availability and use of PPEs as well as self-reported occupational exposures among workers in surveyed small industries in Jeddah. The study involved 102 workers from 28 small-scale industries (vehicle repair, welding, and paint). A survey was conducted to gather data of socio-demographic characteristics, self-reported occupational exposures, and frequency of PPEs used by workers. The occupational exposures (never exposed, sometimes exposed and always exposed) were reported in percentages including; noise exposure (19.6, 73.5 and 6.9%); dust/smoke exposure (9.8, 69.6 and 20.6%); vapors/fumes exposure (11.8, 60.8 and 27.5%); and direct sunlight (43.1, 56.9 and 0%), respectively. The reported use of different PPEs in descending order was; knee joints mats (50%), welding shields (50%), safety glasses (33.3%), gloves (27.5%), face masks (26.5%), safety shoes (10.8%) and earplugs/ muffs (8.8%). On the basis of this study findings, hand hygiene and general OSH awareness like interventions can be developed which will help in minimizing workplace exposures among small-scale industry workers.

Hand hygiene adherence in relation to influenza season during 6 consecutive years

Hand hygiene (HH) is the single most important measure in reducing the burden of healthcare-acquired infections. Based on 12,740 HH opportunities observed during 6 consecutive years at our tertiary care center, HH adherence among healthcare workers (HCWs) was significantly better during influenza season compared to non-influenza periods, after controlling for important covariables (odds ratio = 1.17, 95% confidence interval 1.05-1.30). This finding suggests that HH awareness is increased during influenza periods, which could have implications for HCW education.

Self perceived hand hygiene among student health professionals in a tertiary care teaching hospital in Southern India

Implementation of and adherence to practice of hand hygiene in a health care organization not only prevents health care- ssociated infections (HAI) but also limits the transmission of micro-organisms.With “Clean Care is Safer Care” as a main agenda of the global initiative taken by WHO on patient safety programs,it is time for developing countries to develop the much-needed policies for implementation of practices,which will prevent the basic infection in health care setups.The subjects involved in this study were assessed for knowledge and practice of hand hygiene.Interestingly,this study revealed that awareness & proper practice of hand hygiene was not satisfactory as the mean range of number of correct answers was 15-17 out of 28 questions.This was despite 83.3% of the sample having said that they got formal training in hand hygiene. The comparison of knowledge of the two groups showed that the nursing students were more knowledgeable than the MBBS students.There was a significant difference in the level of knowledge among Nursing and MBBS students as found in similar studies where the knowledge of Nursing students was better than that of MBBS students. Van de Mortel et al. in 2010 studied the hand hygiene knowledge, beliefs, and practices among nursing and medical students.They found that the knowledge of Nursing students was more than that of Medical students (P < 0.01), which is consistent with our study.

Eeffects of cleaning staff's hand hygien management on staphylococcus aureus infection in hospitalized patients

Objective To explore the effects of cleaning staff's hygienic management intervention on the infection of staphylococcus aureus (SAU) in hospitalized patients. Methods Totals of 450 hospitalized patients from January to August 2016 in each department were selected. Starting from May 2016, the cleaning staff in charge of the departments were involved in the management of hand hygiene. The changes of hand hygiene awareness and infection control knowledge of the cleaning staff before and after the intervention were compared. Staphylococcus aureus infection was monitored in real time, and compared before and after the intervention. Results Before the intervention, the hygiene awareness of the cleaners was (39.81±3.28) , and the hand hygiene rate was 60.15%. After the intervention, the hygiene awareness was (45.22±4.83) , and the hand hygiene rate was 84.28%. The differences before and after intervention were statistically significant (t=2.219, χ2=4.463; P<0.05) . The average score of infection control knowledge before and after the intervention were (39.3±5.6) and (82.8±6.4) respectively, with a statistical difference (t=2.139, P=0.037) . There were 112 cases of staphylococcus aureus infectoin in all departments before the intervention, and 71 cases after the intervention, with a statistical difference (χ2=2.983, P=0.027) . Conclusions To strengthen the management of hand hygiene can effectively improve the hospitalization environment and reduce staphylococcus aureus infection. Key words: Infection; Staphylococcus aureus; Hospitalized patients; Hand hygiene management; Cleaning staff

Description of Hand Hygiene’s Compliance on Nurse of Hemodialysis at Haji Hospital Surabaya

Thousands patients around the world die every day because of infections when they get treatment. This is because the transmission of microbacteria from the hands of health workers. Hand hygiene is the most important aspect to prevent the transmission of microbacteria and preventing HAIs. Hand hygiene awareness of health workers is a fundamental behavior to prevent cross-infection. The purpose of this study was to evaluate the hand hygiene compliance of nurse in Unit Hemodialysis of Hajj General Hospital Surabaya. Type of this research is descriptive research and observations by using a qualitative approach. Data retrieval on the research is an interview with nurse and audit hand hygiene. Research instrument using a questionnaire of hand hygiene and BSI knowledge, and hand hygiene audit form made by WHO. The population in this research was all nurses in Hemodialysis Unit General Hospital Surabaya Hajj that add up to 11 people. The results of this research obtained that compliance with hand hygiene Unit Hemodialysis nurse is 35%. The compliance were still less and has not reached the standards established by the PPI Hajj General Hospital Surabaya that is 100% and still has not reach compliance standards of WHO that is 40%. Hand hygiene compliance was low caused by the low participation of PPI base training and the lack of availability of hand hygiene facility in the Hemodialysis Unit General Hospital Surabaya Hajj. Advice from research were conducting on job training about how to perform hand hygiene and improve hand hygiene facilities in Hemodialysis Units. Keywords: hand hygiene, compliance, nurse