Factors affecting hand hygiene adherence among critical care healthcare workers: A systematic review.
Serena Brunone, Benedetta Dellisanti, Valerio Capitani et al.
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In 30 seconds
This PRISMA-guided systematic review examined factors associated with hand hygiene adherence among healthcare workers in intensive care units and emergency departments. It included 30 studies published between 1994 and 2024, mostly quantitative, with study sample sizes ranging from 25 to 600 workers. The review identified structural and organizational obstacles—including limited supplies, time pressure, poor sink placement, high workload, and overcrowding—as prominent barriers. Skin irritation, glove use, and coworkers’ attitudes were also associated with lower adherence. The authors highlight education and organizational, logistical, and architectural support as relevant responses to persistent barriers.
Key findings
- The review included 30 studies published between 1994 and 2024, with sample sizes ranging from 25 to 600 healthcare workers.
- Limited materials, time constraints, suboptimal sink placement, high workload, and overcrowding were identified as structural or organizational barriers.
- Skin irritation, glove use, and coworkers’ attitudes were also associated with reduced hand hygiene compliance.
Why it matters
Hand hygiene adherence in critical care settings is shaped not only by individual behaviour but also by the working environment. Recognising practical barriers such as supply access, workload, and sink placement can help frame improvement efforts around the conditions in which care is delivered, alongside ongoing education.
What to keep in mind
The review included studies with varied sample sizes and was mostly based on quantitative studies; the abstract does not report pooled effect estimates.