Practice Nurses Research Articles

The influence of parental perceptions of vulnerability on quality of life in pediatric cancer patients aged 5-7 years.

This study examined the relationship between parental perceptions of child vulnerability and quality of life (QOL) in children aged 5-7years diagnosed with cancer. Specifically, it investigates how parental perceptions influence children's QOL and provides insights into psychosocial support strategies for families facing this challenge. This descriptive and correlational study involved children aged 5 to 7years diagnosed with cancer, along with their parents. A total of 117 children and their parents participated. Data were collected using the Sociodemographic and Clinical Characteristics Form, the Child Vulnerability Scale (CVS), and the Pediatric Quality of Life Inventory (PedsQL). Both the parent and child forms of the PedsQL were used. Statistical analyses included t-tests, correlation, and regression analyses. The results indicate that a significant proportion of parents (69.2%) perceive their children as vulnerable, negatively affecting their children's QOL. The Child Vulnerability Scale showed a negative correlation with several QOL subdimensions, including pain, nausea, procedural anxiety, worry, cognitive problems, and communication. Parental perceptions of vulnerability were associated with lower QOL scores on both the parent and child forms of the PedsQL. Notably, child perceptions of vulnerability explained only 22.2% of the variance in QOL. This study highlights the critical role of parental perceptions in shaping the QOL of children with cancer. Managing and supporting parents' perceptions is essential to improving children's QOL and the effectiveness of healthcare services. This study has significant implications for nursing practice, emphasizing the importance of guiding and supporting parents to optimize their children's QOL. Furthermore, it sheds light on the tendency of parents of chronically ill children to perceive them as vulnerable, providing valuable insights for more sensitive and effective care. However, the study's limitations suggest the need for more extensive research with larger and more diverse sample groups, which could significantly advance nursing practice.

Task Profiles of Academically Qualified Psychiatric Nurses in Germany: Results of a Cluster Analysis.

As little clarity exists regarding the roles of academically qualified nurses in Germany it is not certain that nurses who call themselves "nursing experts" actually perform the tasks of a nursing expert or APN. An important aspect of the present "Study on the situation of academically qualified nurses in psychiatric care contexts in Germany" (AkaPP study) was therefore to identify profiles or clusters based on the tasks and activities performed by academically qualified psychiatric nurses in Germany. To identify possible clusters of academically qualified psychiatric nurses working in direct care practice, nursing development or nursing research positions in relation to their self-described tasks and activities. Data were collected via an online survey between August and November 2020. The target group of the study was academically qualified nurses in Germany working in a psychiatric-psychosocial healthcare institution. The group of interest for the analysis was the subgroup of nurses in a "direct care and scientific nursing role" (academically qualified nurses working in direct patient care, nursing development or nursing research positions; n = 105 valid cases). A hierarchical cluster analysis was carried out using the Ward method on the basis of the tasks and activities described by the participants in the questionnaire. The identified clusters were described in terms of descriptive statistics against the background of previously defined content characteristics and compared for noticeable differences. Reporting was performed according to the STROBE checklist. Cluster analysis revealed the following seven clusters of academically prepared nurses: (1) Practice Development and Consultative Expertise, (2) Basic Nursing Practice, (3) Advanced Practice Development and Nursing Research, (4) Specialised and Expanded Psychiatric Nursing Practice, (5) Basic Psychiatric Nursing Practice, (6) Direct Patient Care and Basic Practice Development and (7) Advanced Psychiatric Nursing Practice. The clusters identified provide a nuanced understanding of the roles of graduate psychiatric nurses in Germany. This insight helps to tailor staffing structures and training programs to the needs of psychiatric care settings. By delineating distinct role profiles, healthcare institutions and policymakers can optimise resource allocation, enhance interdisciplinary collaboration and ultimately improve patient outcomes. This research provides guidance for refining clinical practice models and promoting professional development in psychiatric nursing contexts.

Assessing the Relationship Between Knowledge, Attitude, and Practice Regarding Elder Abuse With Caring Behaviours Assessment Among Nurses: An Exploratory Study.

This study aims to explore the relationship between nurses' knowledge, attitudes, and practices regarding older adult abuse and their caring behaviours, focusing on Iranian nurses. A cross-sectional exploratory study. A cross-sectional correlational design included 250 nurses from medical education centres in Ardabil. A three-part questionnaire assessed demographic characteristics, knowledge, attitudes, and practices regarding elder abuse and caregiving. Data were collected from August to October 2024 and analysed using ANOVA, t-tests, Pearson correlations, and multiple regression analysis. The study's findings are significant, revealing a moderate level of knowledge among nurses about older adult abuse. There are significant positive correlations between knowledge, attitudes, and caring behaviours, with higher education levels associated with better caring behaviours. However, practice scores did not align with knowledge and attitudes, indicating barriers such as workload and lack of training. The findings reveal a significant link between nurses' knowledge and attitudes toward older adult abuse and their caring behaviours. Positive attitudes are associated with higher Caring Behaviours Assessment scores, suggesting that educational programs should enhance nurses' understanding and empathy toward older adult care. Addressing the identified gaps in knowledge and practice can lead to improved patient outcomes and a more compassionate healthcare environment for older adults. It is crucial to provide continuous training and support to empower nurses to apply their knowledge in practice effectively. The study highlights the necessity for regularly occurring targeted educational interventions to enhance nurses' understanding of older adult abuse. Implementing continuous professional development programs for nurses can significantly improve patient outcomes and reduce instances of abuse. Healthcare organisations should foster supportive environments that encourage the regular reporting of suspected cases of abuse and ensure that nurses are consistently updated on best practices. Increasing community awareness about elder abuse is crucial for safeguarding vulnerable older adults. EQUATOR guidelines were followed using the STROBE reporting method. This study did not include patient or public involvement in its design, conduct, or reporting. Only nurses were involved in data collection.

Congenital Adrenal Hyperplasia: A Clinical Review

CYP21A2 genes code for 21-hydroxylase (21OH), an enzyme required for the production of cortisol and aldosterone by the adrenal cortex. Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder that occurs when both copies of a patient’s CYP21A2 genes are mutated and their ability to produce the adrenal cortical hormones cortisol, and also aldosterone in severe cases, is compromised but their production of adrenal androgens is increased. Neonates with severe CAH will experience life-threatening acute adrenal crisis unless promptly diagnosed and appropriately managed. CAH-induced adrenal crisis presents most critically with hypotension, hyponatremia, hypoglycemia, and hyperkalemia, as well as with less specific symptoms (fatigue, nausea, and vomiting). CAH is also the most common cause of androgenized genitalia in 46XX newborns. Patients with severe CAH will require lifelong hormone replacement and “sick day” dosing in response to physiologic stressors. Adults with CAH face lifelong health challenges, many associated with reproduction. Thus, a practitioner including an advanced practice nurse could encounter a patient with CAH in the emergency department or primary care office. This clinical review discusses the pathophysiology, presentation, diagnosis, and management of CAH. Its goal is to prepare advanced practice nurses and other practitioners to recognize CAH and contribute to the care of patients with CAH across the lifespan, with the goal of reducing complications.

Calling Attention to the Practice of Acute and Critical Care Nursing.

Calling Attention to the Practice of Acute and Critical Care Nursing.

GLOBAL EXPERIENCE OF ADVANCED PRACTICE NURSES IN PRIMARY HEALTHCARE: A LITERATURE REVIEW

Introduction. The literature review emphasizes the growing role of advanced practice nurses (APNs) in primary healthcare at the international level. Amid global changes in healthcare systems, these professionals are becoming pivotal in enhancing both access to healthcare services and the quality of care. Aim of the Study. To investigate the global experience of advanced practice nurses within the context of primary healthcare. Materials and Methods. A search of scientific publications was conducted using the PubMed, Scopus, Web of Science, and Google Scholar databases, employing the following keywords: «advanced practice nurses,» «primary health care,» and «registered nurse.» Study Results. The study results indicate that advanced practice nurses significantly improve the quality of care and patient satisfaction. An analysis of various international models demonstrates the successful integration of these professionals into a team-based approach to treatment, leading to a reduction in physician workload and better population health outcomes. Moreover, the presence of clear regulatory frameworks and educational programs has been noted to enhance the efficacy of nurse practice, making them an integral part of the healthcare system. Conclusion. The international experience of advanced practice nurses showcases their significant impact on the efficiency of primary healthcare delivery. Recommendations for adapting successful practices can serve as a foundation for optimizing healthcare systems in various countries, ensuring more sustainable and effective healthcare provision.

An Immersive Virtual Reality Simulation Scenario to Improve Empathy in Nursing Students.

Empathy is essential in nursing practice and can be taught throughout nursing curriculum using a variety of methods including clinical experiences, in-person simulation, virtual reality, and didactic lecture. Empathy can also change over time, often decreasing the longer nurses practice. A cohort of upper-level nursing students viewed a short immersive virtual reality simulation as part of routine curriculum and completed the Toronto Empathy Questionnaire before viewing (time 1), 2 weeks later (time 2), and, for a small cohort, several months later (time 3). The sample included 110 undergraduate nursing students. There were no improvements in Toronto Empathy Questionnaire scores from time 1 to time 2. There was no improvement from time 1 to time 3 for the cohort who completed the Toronto Empathy Questionnaire three times. There were no significant differences in Toronto Empathy Questionnaire scores between cohorts for any measurement times. Total mean empathy scores were comparatively high in this study and did not decline over time. Although this virtual reality simulation scenario appears to have protected against decline in empathy, it may have been insufficient to foster an increase in empathy scores. Empathic training needs to be immersed throughout their nursing education in both didactic and clinical settings.

Career Growth as a Mediator Between Scope of Practice, Importance of Practice and Emergency Nursing Competency Among School Nurses.

School nurses are sometimes the sole healthcare professionals in schools, highlighting their significant role in delivering emergency care and the vital necessity of their competence in emergency nursing care. The scope of practice and ongoing professional development are hypothesized to play significant roles in enhancing these competencies. Investigate the direct and indirect effects of the scope of current practice and the importance of training on the emergency nursing care competency of school nurses, with career growth serving as a potential mediator. A multi-center cross-sectional study was conducted with a convenient sample of 219 school nurses. Data were collected using the career growth of nurses' scale, the emergency nursing care competency scale for school nurses and the scope of school nursing practice tool. Mediation analysis was used to explore the direct and indirect effects of studied variables. Mediation analysis indicated that the scope of current practice had a significant direct effect on career growth (β = 0.179) and emergency nursing care competency (β = 0.389). The importance of practice also had significant direct effects on career growth (β = 0.164) and emergency nursing care competency (β = 0.220). Additionally, career growth significantly mediated the relationship between both the scope of current practice (β = 0.110) and the importance of practice (β = 0.120) with emergency nursing care competency. The findings emphasis the critical role of career growth as a mediator between the scope and importance of practice and emergency nursing care competency among school nurses. Expanding the scope of practice and emphasising the importance of professional activities can enhance career growth and improve emergency nursing care competencies. Nurses scope of practice and clear career advancement through mentorship, advanced certifications, further education and enforcing policies mandating regular emergency care is crucial. Establishing a regulatory framework to define and expand the scope of practice for school nurses is also important. No patient or public contribution.

Advanced Practice Nurses' Roles and Responsibilities in Advance Care Planning for Older Persons-A Mixed Methods Systematic Review.

To systematically identify, evaluate and synthesise the research literature about (a) the roles and responsibilities of advanced practice nurses (APNs) in the context of advance care planning (ACP) for older persons, (b) the characteristics of APNs' ACP practices and (c) the facilitators and barriers influencing APNs' involvement in ACP. Mixed-methods systematic review. Followed the mixed methods systematic review guidelines outlined by the Joanna Briggs Institute. Three researchers independently screened studies for eligibility using the Covidence Screening Application. The screening involved two stages: titles and abstracts, followed by full-text evaluation. The Mixed Methods Appraisal Tool was used for quality assessment. A convergent integrated synthesis combined quantitative and qualitative data by 'qualitising' quantitative findings into text, enabling integration and thematic analysis to synthesise the results. Medline, CINAHL and Embase were searched from 2012 to 2024 for original research in English, focusing on APNs involved in ACP for individuals aged 65 or older, using qualitative, quantitative or mixed method designs. The review included 19 studies: seven qualitative, nine quantitative and three mixed method designs. Thematic analysis revealed that APNs play a key role in ACP, aligning care with patient preferences through discussions and documentation. Studies from the United States (12), United Kingdom (4), Canada (2) and Australia (1) show varying APN roles and responsibilities. APNs are crucial to ACP, but barriers limit their impact. Overcoming these is key to improving outcomes. APNs clinical expertise and close patient relationships are crucial for aligning care with patient preferences and needs in ACP. However, to fully maximise their contribution, it is essential to overcome barriers such as time constraints, lack of role recognition and insufficient training. Addressing these challenges will enhance the effectiveness of APNs in providing person-centred care. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. No patient or public contribution.

Improving Communication and Workflow Among Advanced Practice Providers and Nurses on Night Shift in an Intensive Care Unit.

In critical care settings during night shift, the number of staff members is reduced and a designated time for structured patient care discussions is often absent. The absence of organized collaboration and shared decision-making strains professional relationships. In a 21-bed cardiovascular intensive care unit, advanced practice providers were frequently interrupted by night shift nurses to discuss nonurgent clinical matters while engaged in patient care activities. This quality improvement project used a preintervention-postintervention design. Surveys were distributed to advanced practice providers and nurses to determine perceptions of communication. All advanced practice providers and nurses working night shift in the cardiovascular intensive care unit were included. Nightly bedside rounds for advanced practice providers and nurses using a goal sheet to improve communication were implemented in the cardiovascular intensive care unit. Preintervention and postintervention scores on survey subscales (perceptions of collaboration, workflow, and communication) were examined with analysis of variance for both groups. Mean scores increased after the intervention for both advanced practice providers and nurses. Scores for perception of collaboration significantly increased for both advanced practice providers and nurses (both P = .01). The score for perception of workflow significantly increased for nurses (P < .001) but not for advanced practice providers. Scores for perception of communication did not significantly change for either group. Implementation of bedside rounds using a goal sheet for advanced practice providers and nurses working night shift in the cardiovascular intensive care unit improved perceptions of collaboration and workflow.

The Management of Chronic Insomnia in Young Children: A Survey of UK General Practice

ABSTRACT Objectives Chronic insomnia (CI), the most common sleep disorder in young children, is associated with negative outcomes for the child and family. This study explores the beliefs, current practice, and understanding of UK primary health care professionals (PCPs) regarding CI in children under 5 years. Method An online survey of UK PCPs (e.g. general practitioners (GPs), practice nurses) recruited through Clinical Research Networks. The survey consisted of Likert-style and closed- questions regarding beliefs, current practice, and training/knowledge. Data were analyzed descriptively. Results Two hundred and ninety-five PCPs took part (mostly GPs, n = 244). Respondents believe that CI has a large impact on children and family. 80% agreed that CI should be managed in health care and 66.3% in primary care. However, consultations with families regarding CI were reported as infrequent. 91.6% agreed that CI should be managed with behavioral approaches, and more than 85% of respondents recommend positive bedtime routines. Respondents had varied confidence and knowledge about management. They had received little to no professional education about CI. Conclusions PCPs recognize the importance of CI and understand some principles of management, though they lack training and confidence. Improved training and awareness of evidence-based resources for support would improve management in primary care.

Mentors' and supervisors' perspectives regarding newly qualified nurses' practice in digitally enabled workplaces: A qualitative study

Contemporary healthcare environments are becoming increasingly reliant on digital health technologies, presenting new opportunities and challenges for the nursing profession and nurses across practice settings and roles. Little is known about newly qualified Canadian nurses' experiences as they transition from academic settings to digitally enabled healthcare workplaces. To explore (1) perceptions of nurse managers, clinical preceptors and educators regarding newly qualified nurses' practice with digital health, and (2) identify strategies to enhance new nurses' practice with digital health technologies as they transition to the workplace. A descriptive qualitative design was used. Fifteen participants representing nurse managers, clinical preceptors, and educators from two Canadian provinces participated in semi-structured interviews. Thematic analysis was applied to analyze the data. Three themes were identified: 1) Onboarding upon joining the workplace, 2) Factors influencing new hires' practice with technology, and 3) Improving the transition experience to the workplace. Newly qualified nurses have strong digital skills and access to technology training; however, they also face challenges that affect their overall transition and practice. Having a broader understanding of digital health during formal education and in the workplace, mentorship and support from mentors and colleagues, user-friendly technologies, and stable nursing practice environments are key for safe practice and can facilitate the transitional experience and professional growth of new nurses. Clearly, digital health is here to stay and will further advance in the years to come. Considering global nursing shortages and the demand for a digitally capable workforce, it is imperative to address gaps and challenges that newly qualified nurses and all nurses face when providing care in digitally enabled healthcare environments.

Preparation and Reliability and Validity Test of the Questionnaire on the Maintenance of Intravenous Catheter in ICU Nurses' Center.

To compile a questionnaire Knowledge, Attitude and Practices (KAP) of ICU nurses on central venous catheter maintenance and test the reliability and validity of the questionnaire. Compile a questionnaire, conduct a questionnaire survey and test the reliability and validity of the questionnaire. The initial questionnaire was formed based on the theory of KAP, combined with literature review and Delphi expert correspondence method; a questionnaire survey was conducted among 334 ICU nurses in five tertiary hospitals, and the reliability and validity of the questionnaire were tested and a formal questionnaire was compiled. The ICU nurses' CVC maintenance KAP questionnaire included 31 items in three dimensions of knowledge, attitude and behaviour. The item content validity (I-CVI) and questionnaire content validity (S-CVI) were 0.889 ~ 1.000 and 0.974, respectively. Exploratory factor analysis extracts three common factors (dimensions), the cumulative variance contribution rate is 65.656%, the Cronbach'α coefficient of the total questionnaire is 0.843, and the Cronbach's α coefficients of the three dimensions of KAP are 0.754, 0.887 and 0.940, respectively. The split-half reliability is 0.816. The test-retest reliability of the total questionnaire is 0.813. The ICU nurses' CVC maintenance KAP questionnaire has good reliability and validity, stable results, comprehensive coverage, and high feasibility. It can be used as a measurement tool to evaluate the maintenance level of CVC for ICU nurses in China. No patient or public contribution.

Suggesting a Doctor of Nursing Practice Degree With a Specialization in Wound Care Filling a Gap in Advanced Practice Nursing: A View Here.

Suggesting a Doctor of Nursing Practice Degree With a Specialization in Wound Care Filling a Gap in Advanced Practice Nursing: A View Here.

The Future of Artificial Intelligence in Mental Health Nursing Practice: An Integrative Review.

Artificial intelligence (AI) has been increasingly used in delivering mental healthcare worldwide. Within this context, the traditional role of mental health nurses has been changed and challenged by AI-powered cutting-edge technologies emerging in clinical practice. The aim of this integrative review is to identify and synthesise the evidence of AI-based applications with relevance for, and potential to enhance, mental health nursing practice. Five electronic databases (CINAHL, PubMed, PsycINFO, Web of Science and Scopus) were systematically searched. Seventy-eight studies were identified, critically appraised and synthesised following a comprehensive integrative approach. We found that AI applications with potential use in mental health nursing vary widely from machine learning algorithms to natural language processing, digital phenotyping, computer vision and conversational agents for assessing, diagnosing and treating mental health challenges. Five overarching themes were identified: assessment, identification, prediction, optimisation and perception reflecting the multiple levels of embedding AI-driven technologies in mental health nursing practice, and how patients and staff perceive the use of AI in clinical settings. We concluded that AI-driven technologies hold great potential for enhancing mental health nursing practice. However, humanistic approaches to mental healthcare may pose some challenges to effectively incorporating AI into mental health nursing. Meaningful conversations between mental health nurses, service users and AI developers should take place to shaping the co-creation of AI technologies to enhance care in a way that promotes person-centredness, empowerment and active participation.

Comprehensive Evaluation of Nurses' Competencies and Performance in Hospital Infection Control Practices: A Case Study of Ali Abad Teaching Hospital, Afghanistan

Hospital-acquired infections (HAIs) remain a significant public health concern, posing challenges to healthcare systems worldwide. Nurses, as frontline healthcare workers, play a critical role in preventing and controlling these infections. However, their knowledge and practices regarding infection prevention and control are often inconsistent, which can lead to varying levels of infection prevention. The primary aim of this study was to assess the awareness, attitudes, and practices of nurses at Aliabad Teaching Hospital in Kabul, Afghanistan, concerning hospital-acquired infections. A descriptive cross-sectional study was conducted over a three-month period, involving 150 nurses working in different departments of the hospital. Data was collected through a structured questionnaire that assessed demographic information, awareness, attitudes, and practices related to infection prevention. The study found that a significant majority of nurses (81.36%) were aware of HAIs, but only 42.5% reported possessing the necessary skills to manage these infections effectively. Nurses who received regular training and used personal protective equipment (PPE) exhibited higher levels of competency in infection control practices. However, there were areas where improvement was needed, particularly in hand hygiene practices and consistent use of PPE. The study concluded that while there is a general awareness of HAIs among nurses, there is a need for continuous training and strengthening infection control measures to enhance patient safety and improve healthcare outcomes.

Family centered care in pediatric cardiac surgery departments: Nurses’ perceptions

Background: Family-centered care (FCC) in pediatric healthcare settings holds significant implications for hospitalized children and their family, as well as for healthcare providers, particularly nurses. This study aims to explore the perceptions of Pediatric Nurses (PN) working in Pediatric Cardiac Surgery departments regarding FCC. Materials and Methods: A cross-sectional study was conducted between November 2021 and July 2022 at two pediatric hospitals and a Cardiac Surgery Center in Athens, Greece. The Family Centered Care Questionnaire–Revised (FCCQ-R) was utilised to assess nurses' perceptions of FCC. This questionnaire consists of 45 items divided in 9 subcategories accessing the current nursing practice and the perceived necessity of FCC. Data analysis was performed using SPSS-28, with a significance level set at α=0.05. Results: 62 nurses were recruited. Most nurses were female (93.5%), with 41.9% aged between 31 and 40 years. Mean scores for the necessity scale and current scale were 25.93 (±5.26) and 17.85 (±4.25), respectively, with Cronbach's alpha coefficients of 0.942 and 0.937, respectively. Predictors of the current scale score included age group 51–60 years (β=4.62, p=0.010) and necessity scale score (β=0.26, p=0.016), whilst predictors of the necessity scale score included years of experience (β=-7.31, p&lt;0.001) and daily scale score (β=0.35, p=0.019). Conclusions: Nurses acknowledge the importance of FCC dimensions but may encounter challenges in consistently applying them in their work. Further strategies may be required to bridge this gap and enhance the integration of FCC principles into pediatric nursing practice.

Advanced Practice Nursing in the Americas: What Challenges Are We Facing?

Advanced nursing practice has expanded the autonomy of nurses, but its implementation in Latin America faces several structural and cultural challenges.

Factors Influencing the Self-Reported Palliative Care Practices of Acute Care Nurses.

Provision of palliative care in acute care settings is significantly lacking despite evidence that early integration leads to better patient/family-related outcomes and improved healthcare cost and efficiency. This study investigated influencing factors that affect the nature and frequency of palliative care practices of acute care nurses. A descriptive, cross-sectional design was used to examine the effects of personal and environmental factors on nurses' palliative care practices in the acute care setting. Registered nurses (N = 325) completed an electronic survey including a demographic questionnaire and 6 other measures to measure the study variables (palliative care practices, palliative care knowledge, self-efficacy, perceived competency, attitudes toward care of the dying, and perceived barriers). Hierarchical multiple linear regression evaluated the degree to which each set of variables explained the variance in self-reported frequency of palliative care practices while controlling for the others. The final regression model with demographics, personal factors, and environmental factors accounted for 32.1% of the variance in the frequency of nurses' self-reported palliative care practices and was significant (F[14, 238] = 8.050, P < .001). Step one (demographics) explained 12.3% of the variance (F[7, 245] = 4.916, P < .001). Step two (personal factors) explained 19.4% (F[5, 240] = 13.678, P < .001). Step three (environmental factors) explained 0.4% (F[2, 238] = 9.053, P = .519). Personal factors, especially self-efficacy and attitudes toward care of the dying, are the most significant influencing factors to the frequency of acute care nurses' palliative care practices.

P-328. Compliance of Hand Hygiene Practice among Health Care Workers in Tertiary Care Military Hospitals of Bangladesh

Abstract Background Hospital-acquired infection is still a major cause of morbidity and mortality in hospitals. Healthcare workers’ (HCWs) hands become progressively colonized with potential pathogens during their patient care and act as a vehicle for transmission of microorganisms to other patients. Hand hygiene (HH) is undisputedly one of the most effective infection control measures. Military hospitals in Bangladesh are known for better compliance of health system practice. This study aimed to evaluate HH compliance and associated factors among HCWs in two tertiary level military hospitals in Bangladesh.Table 1HH practice of Physicans Methods We conducted non-participatory observations at 02 tertiary Combined Military hospitals (CMH) at Dhaka (1650 bedded) and Jashore (500 bedded) during Oct to Dec 2021. We used the WHO’s ‘5 moments of Hand Hygiene tools’ to record HH compliance among physicians, nurses and cleaning staff. We also performed semi-structured interviews to determine the key barriers to complying with HH.Table 2HH practice of Nurses Results We observed total 172 HH opportunities. The overall HH compliance was 30.9%, highest among physicians (34.5%), followed by Nurses (25.2%). Physicians’ performance (49%) on HH practice before touching a patient was higher than the nurses (46%) but poorer (44.5%) after touching the patient than same practice of nurses (58%). Study also observed that only 24% physicians and 18% nurses practiced HH Before and after handling patient file. Responded opined that workload, shortage of time, lack of facility, distance of hand washing station, inadequate supply were the key hand hygiene barriers with soap. Insufficient supply, skin reaction, cost of product, lack of knowledge appeared. Qualitative assessment revealed that Inadequate handwashing station at wards (distance), insufficient training &amp; orientation for HCWs, irregular monitoring and audit and lack of enforcement of IPC guidelines were key challenges at both study sites.Table 3HH practice barrier with soap Conclusion HH compliance among HCWs of study hospital was short of standard for safe patient care. Periodical training and motivation, ensuring HH supplies and enforcement of IPC guideline is needed to improve the situation.Table 4HH practice barrier of sanitizer Disclosures All Authors: No reported disclosures