Improving Quality and Compliance of Surgical Hand Scrubbing Practices: A Clinical Audit

Abstract

Background Surgical site infections (SSIs) are a critical concern in healthcare, particularly in developing countries, where they are among the most prevalent and challenging hospital-acquired infections. Adherence to proper hand hygiene practices is essential to prevent SSIs. However, compliance among surgical teams remains suboptimal due to factors such as time constraints, lack of training, and resource limitations. This study evaluates and enhances adherence to surgical hand scrubbing protocols at Osman Degna Teaching Hospital using World Health Organization (WHO) guidelines. Methods An observational cross-sectional audit was conducted in two cycles between August and October 2024, with 54 observations per cycle. Baseline adherence was assessed in the first cycle. Targeted interventions, including video demonstrations, hands-on training, and feedback, were implemented before the second cycle. Data were collected using a structured checklist and analyzed quantitatively to compare compliance rates and qualitatively to identify barriers to adherence. Results Compliance with hand scrubbing protocols improved significantly from 63.1% in the first cycle to 94.3% in the second. The most notable improvement (51.5%) was observed in rotational rubbing with clasped fingers. Other areas, including scrubbing palms and rinsing hands, showed substantial increases (30.3-42%). These findings highlight the effectiveness of structured training and feedback in enhancing adherence. Conclusion Targeted educational interventions significantly improved compliance with surgical hand scrubbing protocols, contributing to better infection control practices. While these improvements demonstrate the potential of training programs, continued efforts and long-term strategies are necessary to sustain progress and further reduce the risk of SSIs.