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Asian Journal of Nursing Education and Research
Year : 2021, Volume : 11, Issue : 1
First page : ( 123) Last page : ( 128)
Print ISSN : 2231-1149. Online ISSN : 2349-2996.
Article DOI : 10.5958/2349-2996.2021.00032.X

Impact of multimodal intervention strategies on compliance to hand hygiene practices among staff nurses in Obstetric and gynaecological wards

Mary VJ1,*, Thomas Salomi2, Rao Suman3

1Tutor, Department of Child Health Nursing, St. Johns College of Nursing, Bangalore

2Associate Professor, Department of Child Health Nursing, St. Johns College of Nursing, Bangalore

3Professor and Head of NICU, St. Johns Medical College Hospital, Bangalore

*Corresponding Author Email: maryvj22@gmail.com

Online published on 27 April, 2021.



Hand hygiene is the most measure in the prevention of health care - associated infection (HCAI). Adherence to hand hygiene protocols in hospital by nurses enables in prevention and control the HCAI.

Objective and Design

This Quasi experimental one group pre-intervention and post intervention study compares the compliance to hand hygiene practices before and after a multimodal interventional strategy.


Obstetrics and gynecology ward and private wards of a tertiary care hospital in Bangalore.

Subject and Intervantion

Nurses working in the postnatal wards were enrolled in the study by purposive sampling. The staff nurses were observed for their hand hygiene compliance before and after a multimodal intervention strategy. The intervention consisted of educational initiatives, reinforcement of HICC protocol by demonstration and lectures, visual and verbal reminders, ensuring availability of hang hygiene solutions and individual and group teachings. The hand hygiene technique was scored on a validated tool.

Statistical Analysis

A sample size of 64 nurses was needed for the study to have a power of 80% and α error of 5%. Mean pretest and post test scores were compared by t test. Associations with baseline variables were done by ANOVA.

Outcome Measures

Hand hygiene compliance among staff nurses has improved significantly following multimodal intervention strategies from 45.31% to 65.78%. (P<0.001). There was also significant improvement in the techniques of hand hygiene (hand wash technique mean score improved from 5.97 ± 1.284 to 8.16 ± 1.158 (p < 0.05) and hand rub technique score from 4.52 ± 0.992 to 6.69 ± 1.489(p < 0.05)). Hand hygiene in the private wards was significantly better than the common wards.


The multimodal intervention strategy including constant reinforcement, training sessions and motivation improved compliance to hand hygiene practices among staff nurses.



Hand hygiene, Compliance, Multimodal intervention, Staff Nurses.


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