An Evaluation of Factors Impeding Adherence to Established Hand Hygiene Protocols Among Medical Students at Three University Teaching Hospitals in Zambia

Abstract

Objective: To assess the obstacles affecting compliance with established hand hygiene protocols among medical students at university teaching hospitals Design and Methods: The study was conducted at Ndola Teaching Hospital, Kitwe Teaching Hospital, Copperbelt University Dental Clinic, and Arthur Davidson Children’s Hospital, serving as training sites for medical students at Copperbelt University School of Medicine in Zambia. The target population were Bachelor of Medicine and Bachelor of Surgery (MBChB) and Bachelor of Dental Surgery (BDS) students in their clinical years. The research employed a cross-sectional descriptive questionnaire-based study to evaluate the factors hindering compliance to hand hygiene protocols. A non-probability quota sampling technique was applied, stratifying participants by clinical year for a comprehensive representation. Results: The sample was derived from a population of 497 students, using EpiInfo Build Number 1.4.3 at a confidence level of 95%, an expected value of 50% and a confidence limit of 5%. A required sample of 217 was needed and factoring in an assumed response rate of 70%, at least 300 questionnaires were distributed in which there was a response rate of 81% resulting in a sample size of 244. Lack of facilities was the major self-reported factor limiting compliance at 50.4%, lack of knowledge and facilities at 17.2%, lack of knowledge at 10.2% and a personal failure to adherence at 9.8% while 12.3% reported no factors. Conclusion: A multi-faceted approach that combines improvements in facilities, educational initiatives, and addressing individual attitudes is essential for enhancing hand hygiene practices. By addressing the identified barriers comprehensively, healthcare settings and individuals can collectively contribute to effective infection prevention.