Evaluation of Hand Hygiene Compliance Barriers Across Neonatal Care Wards Following a Multi-Modal Strategy

African Journal of Nursing and Midwifery | Vol. 14, No. 9, September 2026 | pp. 271–279

DOI: 10.46882/2026/AJNM/000162

Original Research Article

Title: Evaluation of Hand Hygiene Compliance Barriers Across Neonatal Care Wards Following a Multi-Modal Strategy

Names of Authors: Ruth N. Kamau¹, Fatou B. Cisse²

Authors’ Affiliations:
¹School of Nursing Sciences, University of Nairobi, Kenya
²Faculty of Medicine and Nursing, Cheikh Anta Diop University, Dakar, Senegal

Abstract:
Nosocomial bacterial transmissions within high-risk infant units drive clinical neonate morbidity, requiring strict adherence to universal sanitization behaviors. This study evaluated long-term hand hygiene compliance markers following the deployment of a structured, multi-modal intervention package inside public hospital neonatal nurseries. A timed, non-participatory observation methodology tracked 110 pediatric care nurses across 450 clinical opportunities before and 6 months following the integration of localized sanitizer access points, continuous visual cue displays, and routine performance reviews. Quantitative results showed that overall hand hygiene compliance grew from 42.3% at baseline to 78.5% post-intervention (p < 0.001). Despite this overall progress, compliance markers prior to starting clean procedures lagged significantly behind post-contamination intervals (54.6% vs 88.4%, p < 0.005). The primary lingering structural barriers reported included critical infant over-crowding and acute structural skin damage from low-grade chemical scrubs (58.3%). While multi-modal campaigns significantly upgrade baseline hygiene adherence, sustaining safety benchmarks requires correcting severe staffing levels and accessing medical-grade moisturizers.

Keywords: Hand Hygiene Compliance; Neonatal Care; Multi-Modal Interventions; Hospital Infections; Patient Safety; Clinical Audits.

Manuscript Timeline: Received August 04, 2026; Revised September 14, 2026; Accepted September 25, 2026; Published September 30, 2026.

Citation: Kamau, R. N., & Cisse, F. B. (2026). Evaluation of Hand Hygiene Compliance Barriers Across Neonatal Care Wards Following a Multi-Modal Strategy. African Journal of Nursing and Midwifery, 14(9), 271–279. DOI: 10.46882/2026/AJNM/000162

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