Surgical Hand Scrubbing: A Clinical Audit at a Referral Hospital

Background Surgical site infections (SSIs) continue to be a serious challenge in the medical profession, particularly in developing countries, where they are responsible for a notable percentage of hospital-acquired infections. Although proper hand hygiene continues to be a mainstay for the prevention of SSIs, compliance by surgical teams tends to be less than optimal. Factors such as limited time, inadequate training, and resource constraints are among the reasons behind this persisting problem. This study critically examines and seeks to improve compliance with surgical hand scrubbing protocols at Prince Osman Digna Referral Hospital and referencing standards established by the World Health Organization (WHO). Methods The study employed a three-cycle observational cross-sectional audit conducted from October to December 2024, with each cycle comprising 30 recorded observations. The first cycle established baseline compliance. Following this, targeted interventions, such as instructional videos, practical training sessions, and direct feedback, were introduced. In the next cycle, adherence is re-evaluated. Then, in the final cycle, the same interventions were repeated and reinforced through in-person live demonstrations. Data collection relied on the use of a systematic checklist, allowing for the quantitative analysis of compliance rates and the qualitative identification of barriers to adherence. Results Following the introduction of training and feedback, compliance with hand hygiene protocols increased from 82% to 96% between the last two cycles. The most significant improvement was seen within a minimum time of two minutes during scrubbing, rising by 166%. On the other sites, for instance, drying hands and forearms with a sterile towel also improved significantly, from 30% to 42.8%. Overall, these findings highlight the incredible impact that organized education and ongoing feedback can have on following proper hand hygiene protocols. Conclusion Interventions targeted at education resulted in notable gains in adherence to surgical hand scrubbing protocols, thereby enhancing infection control measures. These findings highlight the effectiveness of structured training. That said, relying on one-off initiatives isn't enough. Sustained educational efforts and long-term strategies are needed to maintain compliance and achieve further reductions in SSIs.

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Journal
Cureus
Published
2025-11-10
DOI
https://doi.org/10.7759/cureus.96465
Primary Topic
Infection Control in Healthcare
Type
article
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0.00
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article

Surgical Hand Scrubbing: A Clinical Audit at a Referral Hospital

Eman Abd El-Mordy Elsayed Ahmed, Mujtaba A Abdelrahem, Md. Abu Sayed, A Bala et al.
Cureus
Infection Control in Healthcare
article

Surgical Hand Scrubbing: A Clinical Audit at a Referral Hospital

Eman Abd El-Mordy Elsayed Ahmed, Mujtaba A Abdelrahem, Md. Abu Sayed, A Bala, Zareen Mohamed, Ahmed Galal Abdelmaged Mohamedahmed
article en

Abstract

Background Surgical site infections (SSIs) continue to be a serious challenge in the medical profession, particularly in developing countries, where they are responsible for a notable percentage of hospital-acquired infections. Although proper hand hygiene continues to be a mainstay for the prevention of SSIs, compliance by surgical teams tends to be less than optimal. Factors such as limited time, inadequate training, and resource constraints are among the reasons behind this persisting problem. This study critically examines and seeks to improve compliance with surgical hand scrubbing protocols at Prince Osman Digna Referral Hospital and referencing standards established by the World Health Organization (WHO). Methods The study employed a three-cycle observational cross-sectional audit conducted from October to December 2024, with each cycle comprising 30 recorded observations. The first cycle established baseline compliance. Following this, targeted interventions, such as instructional videos, practical training sessions, and direct feedback, were introduced. In the next cycle, adherence is re-evaluated. Then, in the final cycle, the same interventions were repeated and reinforced through in-person live demonstrations. Data collection relied on the use of a systematic checklist, allowing for the quantitative analysis of compliance rates and the qualitative identification of barriers to adherence. Results Following the introduction of training and feedback, compliance with hand hygiene protocols increased from 82% to 96% between the last two cycles. The most significant improvement was seen within a minimum time of two minutes during scrubbing, rising by 166%. On the other sites, for instance, drying hands and forearms with a sterile towel also improved significantly, from 30% to 42.8%. Overall, these findings highlight the incredible impact that organized education and ongoing feedback can have on following proper hand hygiene protocols. Conclusion Interventions targeted at education resulted in notable gains in adherence to surgical hand scrubbing protocols, thereby enhancing infection control measures. These findings highlight the effectiveness of structured training. That said, relying on one-off initiatives isn't enough. Sustained educational efforts and long-term strategies are needed to maintain compliance and achieve further reductions in SSIs.

CureusVol. 17(11)
Royal College of Surgeons in Ireland (IE), Royal College of Surgeons of England (GB), University of Khartoum (SD), Royal College of Surgeons of Edinburgh (GB), Al-Neelain University (SD), Universitas Islam Negeri Maulana Malik Ibrahim (ID), Royal College of Veterinary Surgeons (GB), Sinnar University (SD), Wad Medani Ahlia University (SD), University of Bahri (SD), Royal College of Physicians and Surgeons of Glasgow (GB), Red Sea University (SD)
Openalex Percentile: Top 61%
Infection Control in Healthcare
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