Predictors of hand hygiene adherence: A cross-sectional study of nurses in babylon, iraq

Background: Hand hygiene is the most effective method for preventing infections, and nurses' adherence to hygiene practices plays a vital role in patient safety.Objectives: This study aimed to assess hand hygiene adherence and its related factors among nurses in hospitals in Babylon City, Iraq, in 2025.Methods: A cross-sectional study was conducted with 150 nurses working in teaching hospitals in Babylon.Convenience sampling was used, and data were collected using a demographic form, a selfreport questionnaire based on the WHO's "My Five Moments for Hand Hygiene," and a perceived factors questionnaire.Data were analyzed using SPSS v.23 through independent t-test, Mann-Whitney U, Kruskal-Wallis, and logistic regression tests, with significance set at p < 0.05.Results: The mean age of nurses was 27.91 (SD=4.4)years, and most were female (82.7%).Over half had attended infection control (53.3%) and hand hygiene training (59.3%) courses.About 51.3% had a moderate level of knowledge about infection control.Adherence to hand hygiene varied by situation, being highest after exposure to body fluids (90.7%) and after patient contact (86.7%), and lowest before patient contact (66.7%). Conclusion:Hand hygiene adherence was lower in preventive moments, with physical and organizational barriers identified as key challenges.Comprehensive interventions-reducing workload, ensuring access to skin-compatible antiseptics, and providing targeted education-are essential to enhance preventive behavior, improve compliance, and promote patient safety. Implications for Nursing and Midwifery Preventive Care Implement targeted training for male nurses, emphasizing hand hygiene before patient contact to strengthen preventive care. Reduce workload through balanced nurse-to-patient ratios and ensure constant availability of skinfriendly alcohol-based hand rubs at all care points.