Background: Research has shown that Hospital-acquired infections are significantly known to lengthen hospital stays, increase medical expenses, increase morbidity and mortality rates. This burden tend to be higher in low-and middle-income countries, yet, there is little knowledge about nurses’ perceptions on factors responsible for hand hygiene compliance.

Aim: The study explored factors affecting compliance with Hand Hygiene from the perspective of neonatal intensive care nurses and paediatric intensive care unit nurses in a Nigerian Federal University Tertiary Teaching Hospital.

Method: The study was conducted in a Federal University Teaching Hospital in the Southeastern Region of Nigeria between November 2021 and March 2022. A qualitative  ethnographic approach was utilized in the study. Purposive sampling was performed until data saturation was achieved. The study recruited 22 nurses to participate in the study. An in-depth, semi-structured interviews and shadowing of nurses were conducted. Data were compiled, thematically coded, and analysed.

Result: Most of the participating nurses were female (91%). From the reviewed codes, two major themes emerged, which include individual factors with the subtheme of concerns about the health of the patients and attitudes of nurses toward hand hygiene; organisational factors with the subthemes offhand hygiene facility, knowledge of the five moments of hand hygiene, knowledge of glove use, workload, circumstances.

Conclusion: The two key factors identified as responsible for hand hygiene compliance among the nurses were individual factors and organizational factors. Addressing these factors can improve hand hygiene compliance in this study centre, which may help improve the general quality of care and overall neonatal and paediatric patients’ safety.