Assessment of hemodialysis nurses’ performance toward infection prevention and control in Gaza hospitals

Authors

  • Soliman Aladini Albatana University, Sudan, Sudan https://orcid.org/0000-0002-5703-256X
  • Omar Khattab University College of Applied Sciences, Gaza, Palestine, Palestine, State of
  • Mohammed Nemer International University of Africa, Sudan, Sudan
  • Yousef Fahajan Omar Al Mukhtar University, Sudan, Sudan
  • Susan Zroog   Omar AL mukhtar university-Sudan , Sudan

DOI:

https://doi.org/10.53713/nhsj.v6i1.572

Keywords:

Hemodialysis nurses, infection prevention and control, nursing performance, governmental hospitals, Gaza strip

Abstract

Hemodialysis (HD) units are high-risk areas for healthcare-associated infections (HAIs). Nurses play a vital role in infection prevention and control (IPC), yet their adherence to IPC standards can be inconsistent, especially in resource-limited areas like the Gaza Strip (GS). This study aimed to assess the performance of HD nurses in implementing IPC practices at governmental hospitals in the GS. A descriptive cross-sectional study was conducted in six governmental hospitals, involving 112 registered nurses working in HD units. Data were collected using a structured, self-administered questionnaire covering demographic characteristics, IPC-related knowledge, and self-reported performance. SPSS version 26 was used for both descriptive and inferential analysis. Nurses showed moderate IPC knowledge (mean = 78.4%, SD = 8.5) and performance (mean = 62.3%, SD = 12.1). Performance varied across domains, with the highest scores in injectable medication preparation (mean = 11.92, SD = 3.59) and the lowest in dialysis station disinfection (mean = 5.44, SD = 2.94). Significant differences in IPC performance were associated with gender, hospital location, and type of HD service (p < 0.001), with pediatric HD nurses demonstrating the highest compliance. HD nurses' performance is moderate, with gaps in environmental hygiene. These results highlight the need for training and monitoring targeted to enhance infection control and promote patient safety.

References

Abban, M. K., Ayerakwa, E. A., Mosi, L., & Isawumi, A. (2023). The burden of hospital acquired infections and antimicrobial resistance. Heliyon, 9(10), e20561. https://doi.org/10.1016/j.heliyon.2023.e20561

Abbas, S. (2024). The challenges of implementing infection prevention and antimicrobial stewardship programs in resource-constrained settings. Antimicrobial Stewardship & Healthcare Epidemiology, 4(1), e45. https://doi.org/10.1017/ash.2024.35

Abbasi, S. H., Aftab, R. A., Lai, P. S. M., Lim, S. K., & Zainol Abidin, R. N. (2021). Impact of Healthcare Associated Infections on Survival and Treatment Outcomes Among End Stage Renal Disease Patients on Renal Replacement Therapy. Frontiers in Pharmacology, 12, 707511. https://doi.org/10.3389/fphar.2021.707511

Al-Tawfiq J. A. (2025). Striving for zero traditional and non-traditional healthcare-associated infections (HAI): a target, vision, or philosophy. Antimicrobial Stewardship & Healthcare Epidemiology: ASHE, 5(1), e146. https://doi.org/10.1017/ash.2025.10031

Alfano, G., Morisi, N., Giovanella, S., Frisina, M., Amurri, A., Tei, L., Ferri, M., Ligabue, G., & Donati, G. (2025). Risk of infections related to endovascular catheters and cardiac implantable devices in hemodialysis patients. The Journal of Vascular Access. https://doi.org/10.1177/11297298241240502

Amaro, A., Velez, B., Singer, A., Torcivia, P., Dimino, K., & Camiling-Burke, A. (2025). Nurses leading the way: Transforming CLABSI prevention. Nursing Management, 56(9), 32–36. https://doi.org/10.1097/nmg.0000000000000300

Bello, A. K., Okpechi, I. G., Levin, A., Ye, F., Damster, S., Arruebo, S., Donner, J. A., Caskey, F. J., Cho, Y., Davids, M. R., Davison, S. N., Htay, H., Jha, V., Lalji, R., Malik, C., Nangaku, M., See, E., Sozio, S. M., Tonelli, M., Wainstein, M., … ISN-GKHA Group (2024). An update on the global disparities in kidney disease burden and care across world countries and regions. The Lancet Global health, 12(3), e382–e395. https://doi.org/10.1016/S2214-109X(23)00570-3

Davies, S., Naicker, S., Liew, A., Vachharajani, T., Pecoits-Filho, R., Jha, V., Finkelstein, F., & Harris, D. C. (2025). The International Society of Nephrology Collaborative Quality Framework to Support Safe and Effective Dialysis Provision in Resource-Challenged Settings. Kidney International Reports, 10(3), 663-672. https://doi.org/10.1016/j.ekir.2024.11.1366

El-Kass, A., Ahmed, N., Kannan, T., Shediq, N. A., & Dirani, E. E. (2024). Nurses’ knowledge toward hemodialysis vascular access devices: A cross-sectional study in Palestine. SAGE Open Medicine, 12, 20503121241264444. https://doi.org/10.1177/20503121241264444

Elangovan, S., Lo, J., Xie, Y., Mitchell, B., Graves, N., & Cai, Y. (2024). Impact of central-line-associated bloodstream infections and catheter-related bloodstream infections: A systematic review and meta-analysis. Journal of Hospital Infection, 152, 126-137. https://doi.org/10.1016/j.jhin.2024.08.002

Falodun, M. O., Olorunfemi, O., & Irinoye, O. O. (2025). Infectious diseases: Addressing global challenges and prevention strategies for national health improvement. Community Acquired Infection, 12. https://doi.org/10.54844/cai.2024.0533

Gašpert, T. (2025). The Vital Role of Nurses in IPC. In Principles of Nursing Infection Prevention Control: Introduction and global context of Infection Prevention and Control (Volume 1) (pp. 17-34). Cham: Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-84469-0_3

Hamamra, B., Abuzant, M., & Mahamid, F. (2025). The Decimation of Gaza's Health Care System—Hospitals Destroyed and Lives Endangered. International Journal of Social Determinants of Health and Health Services. https://doi.org/10.1177/27551938251378096

Hinson, C., Kilpatrick, C., Rasa, K., Ren, J., Nthumba, P., Sawyer, R., & Ameh, E. (2024). Global surgery is stronger when infection prevention and control is incorporated: a commentary and review of the surgical infection landscape. BMC surgery, 24(1), 397. https://doi.org/10.1186/s12893-024-02695-7

Iqbal, F., Siva, N., Shenoy, P. A., Lewis, L. E. S., Purkayastha, J., & Vandana, K. (2025). Reducing hospital-acquired infections in the NICU: Nurse-led quality improvement strategies. Journal of Neonatal Nursing, 31(4), 101699. https://doi.org/10.1016/j.jnn.2025.101699

Irfan, B., Lulu, I., Hamawy, A., Shammala, A. A., Kullab, S., Fawaz, M., Sammour, A. A. K., Khawaja, H., Alshaer, N., Abu-Sittah, G., Alser, O., Perlmutter, M., Al-Shembari, A., Hickey, J., Nayfeh, T., Tahir, M., Sultan, M. J., Nasser, E., Wajahath, M., . . . Saleh, K. J. (2025). Combating infections under siege: Healthcare challenges amidst the military assault in Gaza. World Medical & Health Policy, 17(1), 188-213. https://doi.org/10.1002/wmh3.642

Kuhail, M., Aladini, S. O., Nimer, M., Zroog, S. A., Fahajan, Y. F., & Khattab, O. (2026). Effect of an Infection Prevention and Control Training Program on Hemodialysis Nurses’ Performance in Governmental Hospitals in the Gaza Strip: A True Experimental Study. Frontiers in Health Services, 6. https://doi.org/10.3389/frhs.2026.1733275

Lee, S., & Yang, I. (2025). Scenario-based simulation training as a strategy to improve infection prevention and control adherence: A quasi-experimental study. Applied Nursing Research, 83, 151966. https://doi.org/10.1016/j.apnr.2025.151966

Lubbad, M., Aloul, E., & Botcher, B. (2022). Adherence to US Center for Disease Control and Prevention infection control guidelines in the haemodialysis care unit at Dar Al-Shifa Hospital in the Gaza Strip: A clinical audit. The Lancet, 399, S39. https://doi.org/10.1016/S0140-6736(22)01174-6

Masudi, M., Ejaz, E., Wardak, M. F., Rahimi, A., Shayan, N. A., Obnial, J. C., & Lucero-Prisno, D. E. (2026). Knowledge, Attitude, and the Practice in Nosocomial Infection Control Among Afghan Healthcare Workers in Herat Afghanistan: A Cross-Sectional Study. Health Science Reports, 9(2), e71780. https://doi.org/10.1002/hsr2.71780

Qtait, M., Alqaissi, N., & Jaradat, Y. (2025). Assessment of Nurses’ Knowledge and Behavior Toward Preventing Central Line-Associated Bloodstream Infections in Intensive Care Units and Dialysis Units. Sage Open Nursing. https://doi.org/10.1177/23779608251402958

Qureshi, M. O., Chughtai, A. A., & Seale, H. (2022). Recommendations related to occupational infection prevention and control training to protect healthcare workers from infectious diseases: a scoping review of infection prevention and control guidelines. BMC Health Services Research, 22(1), 272. https://doi.org/10.1186/s12913-022-07673-4

Sandu, A. M., Chifiriuc, M. C., Vrancianu, C. O., Cristian, R. E., Alistar, C. F., Constantin, M., ... & Tantu, M. M. (2025). Healthcare-Associated Infections: The Role of Microbial and Environmental Factors in Infection Control—A Narrative Review. Infectious Diseases and Therapy, 1-39. https://doi.org/10.1007/s40121-025-01143-0

Shaqura, I. I., Baroud, R., & Sari, A. A. (2022). Collaboration among healthcare professionals at the public hospitals in Gaza: a quantitative study. Journal of Integrated Care, 30(1), 106-119. https://doi.org/10.1108/JICA-09-2020-0057

Sikka, G., Farooq, S., Patel, B., & Prada, R. A. (2024). Strategies to prevent central line-associated bloodstream infections (CLABSIS). In Infection Prevention in the Intensive Care Setting (pp. 15-31). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-031-67062-6_3

Singh, S., Pandey, H., Aggarwal, H. K., & Pal, S. (2023). Assessing the Impact of Training on Healthcare Providers' Adherence to Infection Control Measures in Hemodialysis Services. Cureus, 15(8), e42978. https://doi.org/10.7759/cureus.42978

Tabash, M., Abu Saada, A., AbuQamar, M., Mansour, H., Alajerami, Y., & Abushab, K. (2024). Infection control measures at diagnostic imaging departments in governmental hospitals, Gaza-Strip. Radiography, 30(2), 567-573. https://doi.org/10.1016/j.radi.2024.01.005

Tafere, T. Z., Belachew, T. B., Feleke, D. G., & Adal, G. M. (2024). Assessment of knowledge and practice of nurses regarding infection prevention and associated factors at Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia. Frontiers in Public Health, 11, 1225570. https://doi.org/10.3389/fpubh.2023.1225570

Wooten, R., Kothari, D., Pryor, R., & Bearman, G. (2022). Preventing hemodialysis catheter-related bloodstream infections: barriers, controversies, and best practices. Current Infectious Disease Reports, 24(1), 21-27. https://doi.org/10.1007/s11908-022-00773-6

Yilma, M., Taye, G., Tefera, M., Tassew, B., Fentie, A. M., & Abebe, W. (2024). Exploring barriers to and facilitators of infection prevention and control practices in the Pediatrics and Child Health Department of Tikur Anbessa Specialized Hospital, Ethiopia. Antimicrobial Resistance & Infection Control, 13(1), 121. https://doi.org/10.1186/s13756-024-01475-5

Downloads

Published

2026-03-17

How to Cite

Aladini, Soliman, Omar Khattab, Mohammed Nemer, Yousef Fahajan, and Susan Zroog . “Assessment of Hemodialysis nurses’ Performance Toward Infection Prevention and Control in Gaza Hospitals”. Nursing and Health Sciences Journal (NHSJ) 6, no. 1 (March 17, 2026): 13–24. Accessed April 20, 2026. https://www.nhs-journal.com/index.php/nhs/article/view/572.

Issue

Section

Articles

Citation Check