"Clean Hands, Safe Care: Advancing Hand Hygiene Compliance for Effective Infection Prevention in Acute Care Settings"

Abstract: Healthcare-associated infections (HAIs) continue to pose a significant threat to patient safety, healthcare quality, and economic sustainability worldwide, particularly within acute care settings where patients are highly vulnerable. Among all infection prevention strategies, hand hygiene remains the most effective, evidence-based, and cost-efficient intervention for reducing the transmission of infectious agents. Despite clear international guidelines and decades of research supporting its effectiveness, compliance with hand hygiene practices among healthcare professionals remains suboptimal. This review article critically examines the role of hand hygiene compliance in infection prevention within acute care settings, with a particular focus on nursing practice. It explores the epidemiology of HAIs, the microbiological basis of hand transmission, global hand hygiene guidelines, factors influencing compliance, barriers and facilitators, the impact of education and behavioral change strategies, technological innovations, leadership and organizational culture, and the role of monitoring and feedback systems. The review also highlights the consequences of poor compliance and emphasizes the nurse’s pivotal role in promoting sustainable hand hygiene practices. Strengthening hand hygiene compliance through multifaceted, system-based approaches is essential for improving patient outcomes, reducing HAIs, and ensuring safe, high-quality care in acute healthcare environments.