Hand Hygiene Compliance Among Nurses in Elderly Care Wards : a Descriptive Literature Review

Abstract

Hand hygiene is vital for infection prevention in elderly care, yet nurses’ adherence remains inconsistent. This descriptive literature review assessed factors influencing hand hygiene compliance among nurses in elderly wards and identified strategies to improve adherence. Twelve peer-reviewed articles published between 2020 and 2024 were retrieved from CINAHL, PubMed, and MEDLINE. Data were analysed using inductive content analysis, and study quality was assessed with the JBI Critical Appraisal Tool. The review found that individual, organisational, environmental, and social factors shape compliance. Common barriers included limited knowledge, heavy workload, time pressure, misconceptions about glove use, and inadequate access to hygiene supplies. Facilitators included ongoing education, managerial support, resource availability, positive role modelling, and a strong safety culture. Multimodal interventions combining education, reminders, feedback, and leadership involvement showed the greatest effectiveness. Overall, improving hand hygiene compliance in elderly care requires a comprehensive, sustained approach targeting behavioural, educational, and institutional factors to reduce infection risks among residents.