Background:  Hand washing remains a key measure for intercepting the dispatch of the Coronavirus disease (COVID-19). However, hand washing must be perpetuated properly using soap and water for at least 20 seconds. In response to the current COVID-19 pandemic, various hospitals have imposed mandatory hand washing to everyone prior entering the facilities, and when leaving. This study aimed to assess the hand washing compliance among visitors of a university referral hospital.

Methods: A non-participatory observational study was conducted in the main entrance of the hospital, to measure hand washing compliance of its visitors. The quality of hand washing was assessed via direct observation for compliance with the recommended World Health Organization (WHO) core steps. Data were collected using Open Data Kit (ODK) mobile application.

Results: A total of 1,282 hospital visitors were observed, of which 874(68.2%) were males. Full hand washing compliances were observed among 0.9% (95% CI: 0.4-1.4) of the visitors. Withal, there was no difference in the compliances between genders (0.9% vs 0.7%, P = 0.745). Partial compliance to hand washing was observed  only in three out of ten hospital visitors, 2.9% (95%CI: 2.0-3.8).

Conclusion: Despite the fact that proper hand washing with soap and water is proven to be one of the effective ways in preventing the spread of COVID-19, a significant number of hospital visitors did not practice standard hand washing procedures. Improvements in this measure are urgently needed in the face of the current COVID-19 pandemic.

Keywords: COVID-19; Hand washing; Compliance; Hospital visitors; Ethiopia; Observational study