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Non-compliance with hand hygiene (HH) protocols in hospitals, particularly, is widely recognized as one of the most important contributing and preventable causes of health associated infections.Hence, continuing efforts are being made to identify effective and sustainable strategies to improve HH compliance. Aim:Determinethe effectof hand hygiene strategy among internship nurses on their compliance at different Alexandria University Hospitals. Setting: This study was carried out in six hospitals in Alexandria which all the internship nurses of the Faculty of Nursing have been trained; the MainUniversity , Elhadara, Elshatby, SmouhaUniversity, Student University, and ElmoassatAlexandria University Hospitals . All nurses were enrolled to 5 departments to attain their internship year specialty requirements; Medical-Surgical, Critical, Administration, Pediatric, and Obstetric&Gynecologic departments. Subjects:Subjects of this study comprised all internshipnurses (n=190) available at the previously mentioned settings and providing direct patient 'care. Tools:Two tools were used to collect the data; tool I: Hand hygiene 5moments observation form; was used to measure (HH) compliance after an interventional strategy. Tool II: Hand hygiene intervention strategy, three-phase intervention strategies were provided to all internship nurses at different University Hospitals settings. Results: Themean score of the internship nurses compliance to HH action in the Pediatric department was much better than in Obstetric&Gynecologic one month as well as three months post interventional strategyat both morning and evening shifts. Critical care department showed higher mean score compliance throughout the 5 indications the morning and evening shifts (38.9 %, 46.0% respectively), while the Administration department showed the lowest mean score of compliance (19.4%, 20.0% consecutively). Conclusions:Internshipnurses' compliancewas high in some departments after one month, and declined after three months post strategy. No marked differences were found between morning and evening shifts, in relation to HH compliance in some departments. Recommendations: Compliance strategies should be implemented early and periodically in the clinical courses for internship nurses.

The Effect of Hand Hygiene Strategy on Internship Nurses Compliance at Alexandria University Hospitals: An Empirical Interventional Study