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1- MSc in Nursing, Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Iran. 2- MSc in Nursing, Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Iran. 3- MSc in Nursing, Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Iran. 4- MD. Assistant Professor in neonatology, Department of Pediatrics, Faculty of Medicine, Tabriz University of Medical Sciences, Iran. 5- NICU Msc student, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Student Research Committee, Iran. (Corresponding Author) E-mail: nabdolalipour@yahoo.com

Accepted: 2 August 2014 Received: 11 June 2014

Abstract Introduction: Infection is the main cause of infant mortality in developing countries. The

most effective way to prevent nosocomial infections is hand hygiene, however the existing literature reveals poor performance of the health care workers in this regard. The purpose of this study was to determine the barriers of hand hygiene among the nurses.

Methods: Using descriptive- cross sectional study method, 150 nurses who have worked in the neonatal intensive care units in 4 hospitals of Tabriz, were selected through census sampling. The data were collected via a researcher made questionnaire. Validity of questionnaire was conducted by 14 members of medicine and nursing and midwifery faculty. Reliability was confirmed by using Cronbach's alpha equal to 0/88.

Results: After considering the scores of each questionnaire item, the main causes for non­ compliance with hand hygiene were identified as "inadequate appreciation of the hand hygiene importance, poor attitude towards the effect of hand hygiene on infection control, overcrowded neonatal units, lack of tissue, heavy workload of the staff, and non-compliance of hand hygiene by the head nurse and physician". Individuals with higher work experience introduced managerial obstacles more effectively than other barriers. No statistically significant relation was found with other demographic variables.

Conclusion: A combination of factors that mentioned, can be effective to solving problem Including enhance the nurses belief towards the hand hygiene, standardization of patients numbers in this units, providing adequate tissue, rearrangement of staff numbers when the wards overcrowded, showing of successful samples and hand hygiene compliance of managers.

Keywords: Nurse, Hand hygiene, Barriers, newborn, Cross infection.

Nurses' attitudes towards hand hygiene barriers in the neonatal units of Tabriz Arshadi Bostanabad M 1, Asadollahi M2, J ebrailli M3, Mahallei M4, * Abdolalipuor M5