Compared Hand Hygiene Compliance among Healthcare Providers before and after the COVID-19 Pandemic: A Rapid Review and Meta-analysis

Background: Ebola virus disease (EVD) is highly transmissible and has a high mortality rate. During outbreaks, EVD can spread across international borders. Inadequate hand hygiene places healthcare workers (HCWs) at increased risk for healthcare-associated infections, including EVD. In high-income countries, alcohol-based hand rub (ABHR) can improve hand hygiene compliance among HCWs in healthcare facilities (HCF). We evaluated local production and district-wide distribution of a WHO-recommended ABHR formulation and associations between ABHR availability in HCF and HCW hand hygiene compliance. Methods: The evaluation included 30 HCF in Kabarole District, located in Western Uganda near the border with the Democratic Republic of the Congo, where an EVD outbreak has been ongoing since August 2018. We recorded baseline hand hygiene practices before and after patient contact among 46 healthcare workers across 20 HCFs in August 2018. Subsequently, in late 2018, WHO/UNICEF distributed commercially produced ABHR to all 30 HCFs in Kabarole as part of Ebola preparedness efforts. In February 2019, our crossover evaluation distributed 20 L locally produced ABHR to each of 15 HCFs. From June 24–July 5, 2019, we performed follow-up observations of hand hygiene practices among 68 HCWs across all 30 HCFs. We defined hand hygiene as handwashing with soap or using ABHR. We conducted focus groups with healthcare workers at baseline and follow-up. Results: We observed hand hygiene compliance before and after 203 and 308 patient contacts at baseline and follow-up, respectively. From baseline to follow-up, hand hygiene compliance before patient contact increased for ABHR use (0% to 17%) and handwashing with soap (0% to 5%), for a total increase from 0% to 22% (P < .0001). Similarly, hand hygiene after patient contact increased from baseline to follow-up for ABHR use (from 3% to 55%), and handwashing with soap decreased (from 12% to 7%), yielding a net increase in hand hygiene compliance after patient contact from 15% to 62% (P < .0001). Focus groups found that HCWs prefer ABHR to handwashing because it is faster and more convenient. Conclusions: In an HCF in Kabarole District, the introduction of ABHR appeared to improve hand hygiene compliance. However, the confirmation of 3 EVD cases in Uganda 120 km from Kabarole District 2 weeks before our follow-up hand hygiene observations may have influenced healthcare worker behavior and hand hygiene compliance. Local production and district-wide distribution of ABHR is feasible and may contribute to improved hand hygiene compliance among healthcare workers.Funding: NoneDisclosures: Mohammed Lamorde, Contracted Research - Janssen Pharmaceutica, ViiV, Mylan

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The impact of an education program on hand hygiene compliance and nosocomial infection incidence in an urban Neonatal Intensive Care Unit: An intervention study with before and after comparison

International Journal of Nursing Studies ◽

10.1016/j.ijnurstu.2010.03.005 ◽

2010 ◽

Vol 47 (10) ◽

pp. 1245-1252 ◽

Cited By ~ 58

Author(s):

Onno K. Helder ◽

Johannes Brug ◽

Caspar W.N. Looman ◽

Johannes B. van Goudoever ◽

René F. Kornelisse

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hand Hygiene ◽

Nosocomial Infection ◽

Neonatal Intensive Care ◽

Hand Hygiene Compliance ◽

Intervention Study ◽

Before And After ◽

Hygiene Compliance ◽

The Impact

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Five Indications for Hand Hygiene Compliance among Healthcare Providers in a University Hospital

Klimik Dergisi/Klimik Journal ◽

10.5152/kd.2013.05 ◽

2014 ◽

Vol 26 (1) ◽

pp. 17-20 ◽

Cited By ~ 1

Author(s):

Sevim Sen ◽

Meral Sonmezoglu ◽

Elif Akbal ◽

Esra Ugur ◽

Sibel Afacan

Keyword(s):

Hand Hygiene ◽

Hand Hygiene Compliance ◽

Healthcare Providers ◽

University Hospital ◽

Hygiene Compliance

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Impact of Replacing Powdered Gloves With Powder-free Gloves on Hand-hygiene Compliance Among Healthcare Workers of an Intensive Care Unit: a Quasi-experimental Study

10.21203/rs.3.rs-81396/v1 ◽

2020 ◽

Author(s):

Mayra Gonçalves Menegueti ◽

Fernando Bellissimo-Rodrigues ◽

Marcia A. Ciol ◽

Maria Auxiliadora-Martins ◽

Anibal Basile-Filho ◽

...

Keyword(s):

Intensive Care Unit ◽

Experimental Study ◽

Hand Hygiene ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Latex Gloves ◽

Before And After ◽

Quasi Experimental ◽

Hygiene Compliance ◽

Powdered Latex Gloves

Abstract Background/Objective. After wearing powdered gloves, healthcare workers (HCW) are supposed to wash their hands instead of using alcohol-based hand-rub (ABHR). Washing hands takes longer than using ABHR, and the use of powdered gloves may be an obstacle to hand-hygiene compliance. This study aimed to evaluate the impact of replacing powdered gloves with powder-free gloves on hand-hygiene compliance among HCW of an intensive care unit (ICU). Methods. A quasi-experimental study was conducted in a general ICU of a tertiary care university hospital in Brazil. From June 1st to July 15th, 2017, all HCW were provided with powdered latex gloves only for all clinical procedures. From July 15th to August 31st, 2017, HCW were provided with nitrile powder-free gloves only. Hand-hygiene compliance was assessed through direct observation, and evaluated according to the World Health Organization (WHO) Hand Hygiene guidelines. We calculated that a sample size of 544 hand hygiene opportunities needed to be observed per period. Data analysis were performed using the STATA SE® version 14, and we compared the individual’s percentage of compliance using the t test for paired data before and after the intervention.Results. Overall, 40 HCW were assessed before and after the introduction of nitrile powder-free gloves, with 1114 and 1139 observations of hand hygiene opportunities, respectively. The proportion of compliance with hand hygiene was 55% (95% Confidence Interval [CI]: 51-59%) using powdered latex gloves and 60% (95% CI: 57-63%) using powder-free gloves. The difference in proportions between the two types of gloves was 5.1% (95% CI: 2.5-7.6%, p<0.001).Conclusion. Our data indicate that replacing powdered gloves with powder-free gloves positively influenced hand-hygiene compliance by HCW in an ICU setting.

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Improving children’s and their visitors’ hand hygiene compliance

Journal of Infection Prevention ◽

10.1177/1757177419892065 ◽

2019 ◽

Vol 21 (2) ◽

pp. 60-67 ◽

Cited By ~ 1

Author(s):

Dina Lary ◽

Aaron Calvert ◽

Brigitte Nerlich ◽

Joel Segal ◽

Natalie Vaughan ◽

...

Keyword(s):

Hand Hygiene ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Qualitative Data ◽

Educational Interventions ◽

Structured Interviews ◽

Randomised Study ◽

Cluster Randomised ◽

Before And After ◽

Hygiene Compliance

Background: Numerous interventions have tried to improve healthcare workers’ hand hygiene compliance. However, little attention has been paid to children’s and their visitors’ compliance. Aim: To test whether interactive educational interventions increase children’s and visitors’ compliance with hand hygiene. Methods: This was a cluster randomised study of hand hygiene compliance before and after the introduction of educational interventions. Observations were compared for different moments of hygiene and times of the day. Qualitative data in the form of questionnaire-based structured interviews were obtained. Findings: Hand hygiene compliance increased by 24.4% ( P < 0.001) following the educational interventions, with children’s compliance reaching 40.8% and visitors’ being 50.8%. Compliance varied depending on which of the five moments of hygiene was observed ( P < 0.001), with the highest compliance being ‘after body fluid exposure’ (72.7%). Responses from questionnaires showed educational interventions raised awareness of the importance of hand hygiene (69%, 57%) compared to those who had not experienced the educational intervention (50%). Conclusion: Educational interventions may result in a significant increase in children’s and visitors’ hand hygiene ( P < 0.001).

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Determinants of success and sustainability of the WHO multimodal hand hygiene promotion campaign, Italy, 2007–2008 and 2014

Eurosurveillance ◽

10.2807/1560-7917.es.2017.22.23.30546 ◽

2017 ◽

Vol 22 (23) ◽

Cited By ~ 6

Author(s):

Maria Luisa Moro ◽

Filomena Morsillo ◽

Simona Nascetti ◽

Mita Parenti ◽

Benedetta Allegranzi ◽

...

Keyword(s):

Hand Hygiene ◽

Hand Hygiene Compliance ◽

World Health ◽

Absolute Increase ◽

Italian Regions ◽

Hygiene Promotion ◽

Before And After ◽

Hygiene Compliance ◽

Health Organization ◽

Implementation Progress

A national hand hygiene promotion campaign based on the World Health Organization (WHO) multimodal, Clean Care is Safer Care campaign was launched in Italy in 2007. One hundred seventy-five hospitals from 14 of 20 Italian regions participated. Data were collected using methods and tools provided by the WHO campaign, translated into Italian. Hand hygiene compliance, ward infrastructure, and healthcare workers’ knowledge and perception of healthcare-associated infections and hand hygiene were evaluated before and after campaign implementation. Compliance data from the 65 hospitals returning complete data for all implementation tools were analysed using a multilevel approach. Overall, hand hygiene compliance increased in the 65 hospitals from 40% to 63% (absolute increase: 23%, 95% confidence interval: 22–24%). A wide variation in hand hygiene compliance among wards was observed; inter-ward variability significantly decreased after campaign implementation and the level of perception was the only item associated with this. Long-term sustainability in 48 of these 65 hospitals was assessed in 2014 using the WHO Hand Hygiene Self-Assessment Framework tool. Of the 48 hospitals, 44 scored in the advanced/intermediate categories of hand hygiene implementation progress. The median hand hygiene compliance achieved at the end of the 2007–2008 campaign appeared to be sustained in 2014.

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“If the glove fits”: Hospital-wide universal gloving is associated with improved hand hygiene and may reduce Clostridioides difficile infection

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1422 ◽

2021 ◽

pp. 1-5

Author(s):

Paritosh Prasad ◽

Lynne Brown ◽

Shiyang Ma ◽

Andrew McDavid ◽

Andrew Rudmann ◽

...

Keyword(s):

Hand Hygiene ◽

Hand Hygiene Compliance ◽

Fold Increase ◽

Credible Interval ◽

Clostridioides Difficile ◽

Before And After ◽

Clostridioides Difficile Infection ◽

Quasi Experimental ◽

Hygiene Compliance ◽

Hospital Acquired

Abstract Objective: To determine whether a hospital-wide universal gloving program resulted in increased hand hygiene compliance and reduced inpatient Clostridioides difficile infection (CDI) rates. Design: We carried out a multiple-year before-and-after quasi-experimental quality improvement study. Gloving and hand hygiene compliance data as well as hospital-acquired infection rates were prospectively collected from January 1, 2015, to December 31, 2017, by secret monitors. Settings: The University of Rochester Strong Memorial Hospital, an 849-bed quaternary-care teaching hospital. Patients: All adult inpatients with the exception of patients in the obstetrics unit. Interventions: A hospital-wide universal gloving protocol was initiated on January 1, 2016. Results: Hand hygiene compliance increased from 68% in 2015 reaching an average of 88% by 2017 (P < .0002). A 10% increase in gloving per unit was associated with a 1.13-fold increase in the odds of hand hygiene (95% credible interval, 1.12–1.14). The rates of CDI decreased from 1.05 infections per 1,000 patient days in 2015 to 0.74 in 2017 (P < .04). Conclusion: A universal gloving initiative was associated with a statistically significant increase in both gloving and hand hygiene compliance. CDI rates decreased during this intervention.

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Utilization of Closed Circuit Television in Improving Nurse's Compliance on Hand Hygiene in Budhi Asih Hospital Jakarta

Jurnal Keperawatan Soedirman ◽

10.20884/1.jks.2020.15.2.1204 ◽

2020 ◽

Vol 15 (2) ◽

Author(s):

Ahijrah Ramadhanti ◽

Iwan Dwiprahasto ◽

Hera Nirwati

Keyword(s):

Hand Hygiene ◽

Hand Hygiene Compliance ◽

Health Workers ◽

Individual Characteristics ◽

Control Groups ◽

Regression Test ◽

Before And After ◽

Health Care Associated Infections ◽

Hygiene Compliance ◽

And Control

Health-care associated infections (HAIs) are infectionsoccurring inhospitalized patients.The most effective way to prevent HAIsis throughhand hygiene. However, hand hygiene compliance in health workers is still low. This research aimed to understandtheassociation between CCTVutilizationas a reminder tool inimproving the nurses'hand hygiene compliancein Budhi AsihHospitalJakarta. The study used a quantitativemethod bya quasi-experimentalapproach. The 60 subjects weredivided into two groups:Treatment and Control Groups based on their workplace. Quantitative data wereobtained by filling-in a WHO-standardized questionnaire and observing each group before and after an intervention. Data were analyzed by univariate and bivariate analyses with chi-square test and multivariate analysis with logisticregression test. Nurses' hand hygiene compliance through CCTV observation in Budhi Asih Hospital was 57%. The use of CCTV as reminder media significantly improved hand hygiene compliance (p = 0.002), compliance to 6 steps (p = 0.002) and compliance to the standard time of hand hygiene (p = 0.003). There was no significant correlation between individual characteristics (sex, age, education, working experience, and infection control training participation) with nurses' compliance on hand hygiene. The use of CCTV as reminder media significantly improved nurses' compliance to do hand hygiene.Keywords: CCTV, Reminder, Hand Hygiene, Complience.

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Hand Hygiene Compliance and Associated Factors among Healthcare Workers in Ethiopia: A Systematic Review and Meta-Analysis

Advances in Preventive Medicine ◽

10.1155/2021/7235248 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Negasa Eshete Soboksa ◽

Belay Negassa ◽

GirumGebremeskel Kanno ◽

Zemachu Ashuro ◽

DinkineshBegna Gudeta

Keyword(s):

Systematic Review ◽

Hand Hygiene ◽

Healthcare Workers ◽

Associated Factors ◽

Hand Hygiene Compliance ◽

Positive Attitude ◽

Meta Analysis ◽

Tissue Paper ◽

Hygiene Promotion ◽

Hygiene Compliance

Background. Promoting hand hygiene compliance should be a priority for health authorities and all healthcare facilities at all levels. Therefore, this systematic review and meta-analysis aimed to provide a pooled estimate of hand hygiene compliance and associated factors among healthcare professionals in Ethiopia. Methods. PubMed, Science Direct, EMBASE, the Google search engine, and Google Scholar were used to retrieve studies that were eligible for the study. The searches included all studies published in English prior to July 2021. Using a structured data extraction format, two authors independently extracted the required data. STATA Version 16 software has been used for statistical analysis. To measure the heterogeneity of the studies, the Cochrane Q-test statistics and I2 test were used. Because of the significant heterogeneity, a random-effects model was used. Results. The pooled hand hygiene compliance among healthcare workers in Ethiopia was 38% (95% CI: 0.16–0.59). According to the study’s subgroup analysis, Addis Ababa City administration health workers had the highest hand hygiene compliance, at 73% (95% CI: 0.50–0.96), while SNNP regional state had the lowest, at 9% (95% CI: 0.05–0.13). Presence of hand hygiene promotion (OR: 2.14, 95% CI: 1.04–3.24), towel/tissue paper availability (OR: 3.97, 95% CI: 2.09–5.86), having a positive attitude toward hand hygiene (OR: 1.79, 95% CI: 1.28–2.30), having good knowledge about hand hygiene (OR: 3.45, 95% CI: 1.26–5.64), and being trained for hand hygiene (OR:4.97, 95% CI:1.81–8.14) were significantly associated with hand hygiene compliance. Conclusion. In this analysis, hand hygiene compliance among healthcare workers in Ethiopia was less than half. Providing hand hygiene promotion, towel/tissue paper presence, having a positive attitude toward hand hygiene, having good knowledge about hand hygiene, and being trained for hand hygiene were important variables for the increment of hand hygiene compliance.

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Hand hygiene and glove use in nursing homes before and after an intervention

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1415 ◽

2021 ◽

pp. 1-3

Author(s):

Gwen R. Teesing ◽

Jan Hendrik Richardus ◽

Vicki Erasmus ◽

Mariska Petrignani ◽

Marion P. G. Koopmans ◽

...

Keyword(s):

Clinical Trials ◽

Nursing Homes ◽

Hand Hygiene ◽

Hand Hygiene Compliance ◽

Body Fluids ◽

Improve Hand Hygiene ◽

Trial Register ◽

Before And After ◽

Hygiene Compliance

Abstract We investigated whether an intervention to improve hand hygiene compliance in nursing homes changed glove use. Hand hygiene compliance increased, but substitution of hand hygiene with gloves did not decrease. We observed a reduction of inappropriately unchanged gloves after exposure to body fluids. Clinical trials identifier: Netherlands Trial Register, trial NL6049 (NTR6188): https://www.trialregister.nl/trial/6049.

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