Infection prevention and control practices, barriers, and associated factors among nurses in Bangladeshi hospitals.

BACKGROUND: Hospital-acquired infections (HAIs) remain a serious concern to patient safety, particularly in resource-limited settings. As frontline healthcare professionals, nurses are essential in preventing HAIs through effective infection prevention and control (IPC) compliance. Thus, nurses' knowledge, attitudes, and practices (KAP) on IPC are crucial for IPC success. This study assessed IPC-related KAP among nursing staff of tertiary care hospitals in Bangladesh. METHODS: From January to March 2021, a mixed method survey was conducted across seven public tertiary care hospitals in Bangladesh. A total of 844 nurses participated in the face-to-face interview using a structured questionnaire encompassing 25 KAP questions. Furthermore, 14 key-informant interviews (KII) were conducted to explore the key barriers. Descriptive statistics and multiple linear regression were used to analyze the interview data using Stata version 15, and thematic analysis was performed for KII. RESULTS: Nurses showed strong IPC knowledge (87.8 ± 12.7), but low attitude (59.9 ± 19.8) and self-reported practice (79.1 ± 21.2) scores, demonstrating a discrepancy between high knowledge scores and self-reported IPC practices. Only 38.3% of nurses reported regularly attending the IPC training. Qualitative findings identified staff shortages, high patient turnover, inadequate monitoring and feedback, and limited training facilities as key barriers. Resource shortage (35.5%), workload (34.6%), and skin reactions from hygiene products (30.2%) were the top identified reported barriers to IPC adherence. Younger nurses (< 25 years) had higher overall KAP scores than those aged > 35 years (β = 6.29, 95% CI 2.32-10.28). Similarly, nurses with less than 5 years of experience had a significantly higher overall KAP score (β = 2.41, 95% CI 1.54-4.36) compared to those with more than 10 years of experience. CONCLUSION: Nurses in Bangladeshi public tertiary care hospitals exhibited strong IPC knowledge but had moderate attitudes in translating knowledge into consistent IPC adherence. Tailored training, rational resource allocation, vigilant monitoring and auditing, and strong institutional support are crucial for improving IPC compliance among nurses in resource-constrained healthcare settings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12982-026-02627-1.