Empowering Nurses for Safer Surgeries: A Student-Led Hand Hygiene Initiative to Reduce Surgical Site Infections in Rural India (Uttar Pradesh )

Background: Surgical site infections (SSIs) remain a leading cause of postoperative morbidity in low-resource settings. In rural India, limited access to surgical safety training and low adherence to hand hygiene protocols continue to compromise patient outcomes. Objective: This study aimed to evaluate the effectiveness of a low-cost, nurse-led hand hygiene training program in reducing SSI rates in primary surgical units in Eastern Uttar Pradesh. Methods: A 3-month intervention (Jan–March 2024) was conducted in two district hospitals and four community health centers. A total of 52 nursing staff participated in a structured hand hygiene and sterile field maintenance program, co-designed by medical students and infection control specialists. SSI incidence was tracked for 198 minor and elective surgeries over a 6-month baseline period (July–Dec 2023) and compared to the 3-month post-intervention period. Results: Pre-intervention SSI rate was 9.6%; post-intervention rate dropped to 5.1%, representing a 47% relative reduction. Nurse compliance with hand hygiene increased from 54% to 82% (based on direct observation audits). Staff reported increased confidence, ownership, and patient trust in surgical care quality. Conclusion: Targeted training and behavior change initiatives, led by interdisciplinary student-nurse teams, can have a measurable impact on patient safety. Empowering nursing staff as frontline change agents is a scalable, context-sensitive solution to improving surgical outcomes in low-resource settings.