coronavirus disease {COVID-19} appeared in 2019 and significantly disrupted many areas of life such as healthcare. Health care providers (HCPs), especially nurses and physicians, were on the front lines of fighting the pandemic, making it crucial to follow the recommended safety guidelines. However, many HCPs and hemodialysis (HD) patients were infected by the coronavirus, increasing concerns regarding factors associated with HCPs' adherence level to COVID-19 guidelines. Objective: The purpose of this study was to identify factors associated with health care providers' adherence to COVID-19 guidelines at hemodialysis units. Setting: The study was conducted at the HD units of the Main University Hospital and the Fever Hospital affiliated with the Ministry of Health, Alexandria, Egypt. Materials and Method: A descriptive research design was utilized. ( 60) health care providers showing up at the previously mentioned setting were recruited for the study. Health care providers (HCPs) knowledge of the COVID-19 guidelines structured interview questionnaire, health care providers' adherence to COVID-19 guidelines observational checklist, and factors associated with health care providers' adherence to COVID-19 guidelines structured interview questionnaire were utilized for data collection. Results: Showed most HCPs had unsatisfactory levels of knowledge and adherence toward COVID-19 prevention guidelines (61.7%, 55.0 %) respectively. Moreover, environmental factors were the most factors facing HCPs in their work with an overall percentage score of 78.75 ± 21.50. Also, a highly statistically significant relation was found between HCPs' adherence to COVID-19 guidelines and associated factors such as organizational, environmental as well as individual factors (p = 0.008, 0.005, 0.014) respectively. Conclusion: Most of the studied HCPs had poor knowledge levels and unsatisfactory adherence levels toward COVID-19 guidelines, also the studied HCPs had identified and ranked the obstacles facing them as environmental, organizational, and individual factors.

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