Adherence to WHO Hand Hygiene Protocols in the Surgical Department, Police Hospital, Nile River- Sudan

Abstract Background: Hand hygiene is a simple yet essential practice to prevent healthcare-associated infections (HAIs). However, adherence among healthcare workers is often poor. This study assessed compliance with the WHO “Five Moments for Hand Hygiene” among doctors in the surgical department of Police Hospital, Nile River State, Sudan. Methods: We conducted a prospective observational audit in two cycles (December 2024 and March 2025). Doctors’ adherence to hand hygiene moments was observed directly using a WHO-based checklist. Compliance rates were compared between cycles. Results: Across 147 opportunities in Cycle 1, compliance was 48.9%. In Cycle 2, compliance rose to 93.4% (138 opportunities). The largest improvement occurred in “After body fluid exposure” (27.3% → 91.2%) and “Before aseptic procedures” (76.1% → 100%). Notably, adherence “After touching a patient” decreased from 100% to 66.7%. Conclusion: Educational interventions and supply improvements significantly boosted hand hygiene compliance. Ongoing training, monitoring, and reinforcement will be essential to maintain these gains.