A Comparative Study of Hand Hygiene Compliance Among Nursing Staff in the Intensive Care Unit Versus General Ward at a Secondary Level Public Hospital, Bhakkar

Background: Hand hygiene is essential for preventing healthcare-associated infections, yet adherence may differ across clinical settings. Evidence from secondary-level public hospitals in Pakistan remains limited. Objective: To compare self-reported hand hygiene compliance among nurses working in the intensive care unit (ICU) and General Ward of DHQ Hospital, Bhakkar. Methods: A comparative cross-sectional study recruited 80 nurses (ICU = 34; General Ward = 46) through purposive sampling. A structured questionnaire assessed self-reported hand hygiene frequency across the five World Health Organization moments using a five-point Likert scale. Total scores ranged from 5 to 25. Data were analyzed using Welch's t test, Mann–Whitney U test, and categorical association tests. Results: The questionnaire demonstrated good internal consistency (Cronbach's α = 0.87). Complete-score analyses included 79 nurses. ICU nurses reported higher mean compliance scores than General Ward nurses (22.94 ± 2.32 versus 20.04 ± 5.06; mean difference = 2.90, 95% CI 1.20–4.59; p = 0.001; Cohen's d = 0.70). High self-reported compliance was identified in 84.8% of ICU nurses and 60.9% of General Ward nurses (Fisher–Freeman–Halton p = 0.022). Conclusion: ICU nurses reported significantly higher hand hygiene frequency scores than General Ward nurses. Findings indicate an association between clinical unit and self-reported practices but do not establish actual bedside adherence