High nursing workload is a main associated factor of poor hand hygiene adherence in Beijing, China: An observational study

Int J Nurs Pract. 2019 Apr;25(2):e12720. doi: 10.1111/ijn.12720. Epub 2019 Jan 4.


Aim: The aim of the study was to explore the impact of nurse workloads on adherence to hand hygiene.

Background: Adherence to hand hygiene and nursing workloads have been linked to quality of patient care. Therefore, it was important to understand the relationship to safe patient care.

Design: This cross-sectional study was performed from January 2016 to June 2016.

Methods: Workloads and adherence to hand hygiene for nurses on 3-day shifts in a tertiary hospital were investigated in 2016. Actual hours worked per shift were timed using a stopwatch to assess nursing workloads. Descriptive and inferential statistics and multiple variable regression analysis were used to analyse the data.

Results: Sixty-four nurses from four wards were observed. The average adherence rate of hand hygiene was 26.6% and the average nursing workload per shift was 6.7 hours. Multiple regression revealed that nursing workload was negatively related to adherence rate of hand hygiene.

Conclusion: Nurses in this study that had a low rate of adherence with hand hygiene frequently had high workloads. Adherence to hand hygiene was independently associated with actual hours worked per shift.

Keywords: adherence; hand hygiene; hospital-acquired infections; nurses; nursing workload.

Publication types

  • Observational Study

MeSH terms

  • Beijing
  • Cross-Sectional Studies
  • Guideline Adherence*
  • Hand Hygiene / standards*
  • Hospitals
  • Humans
  • Nursing Staff, Hospital*
  • Patient Safety
  • Quality of Health Care
  • Random Allocation
  • Tertiary Care Centers
  • Workload*