Authors
Ibtisam M Al-Zaru, Abdul-Monim Batiha, Saleh Moh'd Daradkeh, Fadwa Alhalaiqa, Anas H Khalifeh, Suad Elsayed Elsaman, Ahmed Rajeh Saifan
Published in
Journal of research in nursing : JRN. Pages 17449871261445385. Oct 28, 2026. Epub Oct 28, 2026.
Abstract
Hand hygiene (HH) is essential for infection prevention, but compliance in intensive care units (ICUs) often falls short of recommended standards. Leadership-driven audit and feedback could enhance compliance, though its practicality in resource-limited, high-acuity settings is still unclear.
To evaluate the feasibility of a nurse-led, real-time HH audit and feedback intervention in ICUs and to explore contextual barriers influencing its implementation.
A mixed-methods study was conducted over 6 weeks in two Jordanian ICUs. Fourteen supervisors were trained to deliver digital HH audits and real-time feedback. A total of 128 HH observations were recorded pre- and post-intervention, and qualitative data were obtained through post-intervention semi-structured interviews with 22 supervisors.
HH compliance increased from 63.5% to 89.5% (p < 0.001; Cohen's d = 1.29). However, qualitative findings revealed that the intervention was not implemented as intended. Supervisors identified four major barriers: competing workload demands, technological challenges, role ambiguity and lack of managerial reinforcement. Compliance gains were instead attributed to contextual influences, including heightened awareness, peer accountability and observational effects.
In resource-limited ICUs, HH improvement efforts should prioritise low-burden, context-sensitive strategies that leverage peer accountability, observational effects and organisational support mechanisms.
PMID:
42964279
Bibliographic data and abstract were imported from PubMed on 31 Oct 2026.
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