Has the COVID 19 Virus Changed Adherence to Hand Washing among Healthcare Workers?

The aim of the study was to assess adherence to hand washing by healthcare workers (HCWs) and its variations over time in hospital wards. We wanted to check whether the pandemic had changed the behavior of HCWs. The study was conducted between 1 January 2015, and 31 December 2020. The HCWs were observed to assess their compliance with the Five Moments for Hand Hygiene. We described the percentage of adherence to World Health Organization (WHO) guidelines stratified per year, per specialty areas, per different types of HCWs. We also observed the use of gloves. Descriptive data were reported as frequencies and percentages. We observed 13,494 hand hygiene opportunities. The majority of observations concerned nurses who were confirmed as the category most frequently involved with patients. Hospital’s global adherence to WHO guidelines did not change in the last six years. During the pandemic, the rate of adherence to the procedure increased significantly only in Intensive Care Unit (ICU). In 2020, the use of gloves increased in pre-patient contact. The hand-washing permanent monitoring confirmed that it is very difficult to obtain the respect of correct hand hygiene in all opportunities, despite the ongoing pandemic and the fear of contagion.

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Hand hygiene compliance among rural healthcare workers of Nepal

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v5i1.24050 ◽

2018 ◽

Vol 5 (1) ◽

pp. 90-95

Author(s):

Ajay Kumar Rajbhandari ◽

Reshu Agrawal Sagtani ◽

Kedar Prasad Baral

Keyword(s):

Health Care ◽

Hand Hygiene ◽

Healthcare Workers ◽

Compliance Rate ◽

Hand Washing ◽

World Health ◽

Cross Sectional ◽

Hygiene Compliance ◽

Health Organization ◽

Healthcare Associated

Introductions: Transmission of healthcare associated infections through contaminated hands of healthcare workers are common. This study was designed to explore the existing compliance of hand hygiene among the healthcare workers workings in different level of health care centers of Makwanpur district of Nepal. Methods: This was a cross sectional observational study conducted in Makwanpur district, Nepal, during 2015. Healthcare workers from nine healthcare centers were selected randomly for the study. Standard observation checklists and World Health Organization guidelines on hand hygiene were used to assess the compliance of hand hygiene during patient care. Results: There were 74 participants. Overall compliance for hand washing was 24.25% (range 19.63 to 45.56). Complete steps of hand washing were performed by 38.3% of health care workers. The factors associated for noncompliance were lack of time (29.3%), example set by seniors (20%), absence or inadequate institution protocol (20%) and unfavourable health care setting (> 20%). Conclusions: Overall hand washing compliance rate amongst the healthcare workers in rural health facilities of Nepal were low (24.25%).

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Electronic Hand Hygiene Quality and Duration Monitoring in Pre-School Children: A Feasibility Study

International Quarterly of Community Health Education ◽

10.1177/0272684x211033448 ◽

2021 ◽

pp. 0272684X2110334

Author(s):

Mohd Dzulkhairi Mohd Rani ◽

Nurul Azmawati Mohamed ◽

Tengku Zetty Maztura Tengku Jamaluddin ◽

Zarini Ismail ◽

Shalinawati Ramli ◽

...

Keyword(s):

Data Collection ◽

Hand Hygiene ◽

Electronic Device ◽

Hand Washing ◽

World Health ◽

Who Guidelines ◽

Hygiene Practices ◽

Hand Wash ◽

The World ◽

Health Organization

Background Hand hygiene is regarded as the most important measure to prevent spread of infectious diseases. The aim of this study was to assess the feasibility of a prototype application in an electronic device in educating, stimulating and monitoring hand hygiene quality in young children. Method A pre-school was provided with an interactive hand hygiene application for two months. The device features an online administrator dashboard for data collection and for monitoring the children’s hand washing steps and duration. A good hand washing is defined as hand washing which comprise all of the steps outlined in the World Health Organization (WHO) guidelines. Results The prototype managed to capture 6882 hand wash performed with an average of 20.85 seconds per hand wash. Washing hands palm to palm was the most frequent (79.9%) step performed, whereas scrubbing fingernails and wrists were the least (56%) steps performed. Conclusions The device is a good prototype to educate, stimulate and monitor good hand hygiene practices. However, other measures should be undertaken to ensure sustainability of the practices.

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viewpoint TIME TO RESTART: PROTOCOL OF RESUMPTION OF ACTIVITIES OF A DERMATOLOGICAL CLINIC OF A LEVEL II HOSPITAL IN THE COVID-19 ERA. (Preprint)

10.2196/preprints.20732 ◽

2020 ◽

Author(s):

Federico Diotallevi ◽

Anna Campanati ◽

Giulia Radi ◽

Oriana Simonetti ◽

Emanuela Martina ◽

...

Keyword(s):

Healthcare Workers ◽

World Health ◽

New Wave ◽

Staff Members ◽

Level Ii ◽

The World ◽

Health Organization ◽

Spread Of Infection ◽

Hospital Wards ◽

Medical And Healthcare

UNSTRUCTURED Two months have passed since the World Health Organization (WHO) declared the pandemic of the Coronavirus Disease 19 (COVID-19), caused by the SARS CoV-2 virus, on March 11, 2020. Medical and healthcare workers have continued to be on the frontline to defeat this disease, however, continual changes are being made to their working habits which are proving to be difficult. Since the beginning of the pandemic, a major reorganisation of all hospital wards, including dermatological wards, has been carried out in order to make medical and nursing staff available in COVID wards and to prevent the spread of infection. These strategies, which were also adopted in our clinic, proved to be effective, as no staff members or patients were infected by the virus. Now, thanks to the global decrease in SARS-CovV2 infections, it is necessary to make dermatological wards accessible to patients again, but it is also essential to adopt specific protocols to avoid a new wave of infections.

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From Best Evidence to Best Practice – Implementation of a Hand Washing Campaign in the Accident and Emergency Department of the Georgetown Public Hospital Corporation

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2019/v30i1230255 ◽

2019 ◽

pp. 7-8

Author(s):

Jessica Van Meter ◽

Sally Dye ◽

Natansa Amsterdam ◽

Gangapattie Dani ◽

Le-Ann Hamilton ◽

...

Keyword(s):

Hand Hygiene ◽

Best Practice ◽

Clinical Observation ◽

Healthcare Providers ◽

Hand Washing ◽

World Health ◽

Observation Window ◽

Improve Compliance ◽

Baseline Knowledge ◽

Health Organization

Objective: Hand washing compliance amongst emergency healthcare providers is complicated by limited supplies, patient volume, mal-positioning of hygiene materials, and lack of education on the importance of hand hygiene. Design and Methods: A survey was distributed to A&E healthcare staff to determine baseline knowledge about the importance of hand hygiene. Participants were asked to identify departmental obstacles to the practice of proper hand hygiene. Using World Health Organization teaching materials, a hand hygiene clinical observation tool was implemented to determine compliance prior to delivery of tailored education. Education was done utilizing posters, flyers, and powerpoint presentation. Hand sanitizer stations were installed to improve compliance. Finally, the clinical observation tool was implemented following the education initiative to determine impact on provider compliance. A post-implementation survey was distributed to determine if increased education and supplies impacted baseline knowledge and compliance. Results: Only 88% of surveyed providers recognized that the A&E has a current hand hygiene policy with 64% noting GPHC does not stress hand hygiene enough. Providers reported they utilize hand hygiene 75% yet all participants acknowledged that proper hand washing greatly reduces the spread of infection. 53% of providers surveyed felt comfortable encouraging their peers to wash their hands. Conclusions: Initial provider hand hygiene within the A&E was abysmal. Though identified as a predominant barrier, supplies were readily available throughout the observation window. Educational materials placed throughout the department improved both the perception and compliance of hand hygiene. The importance of provider hand hygiene must be continually stressed in order to maintain optimal compliance.

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Hand Hygiene Knowledge and Perception among the Healthcare Workers during the COVID-19 Pandemic in Qassim, Saudi Arabia: A Cross-Sectional Survey

Healthcare ◽

10.3390/healthcare9121627 ◽

2021 ◽

Vol 9 (12) ◽

pp. 1627

Author(s):

Adil Abalkhail ◽

Ilias Mahmud ◽

Fahad A. Alhumaydhi ◽

Thamer Alslamah ◽

Ameen S. S. Alwashmi ◽

...

Keyword(s):

Saudi Arabia ◽

Hand Hygiene ◽

Healthcare Workers ◽

Primary Source ◽

Cross Sectional Study ◽

World Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Government ◽

Health Organization

Hand hygiene is among the most important factors of infection control in healthcare settings. Healthcare workers are the primary source of hospital-acquired infection. We assessed the current state of hand hygiene knowledge, perception, and practice among the healthcare workers in Qassim, Saudi Arabia. In this cross-sectional study, we used the hand hygiene knowledge and perception questionnaire developed by the World Health Organization. Knowledge and perceptions were classified into good (80–100%), moderate (60–79%), and poor (<60% score). The majority of the healthcare workers had moderate knowledge (57.8%) and perception (73.4%) of hand hygiene. Males were less likely to have moderate/good knowledge compared to females (OR: 0.52, p < 0.05). Private healthcare workers were less likely (OR: 0.33, p < 0.01) to have moderate/good perceptions compared to the government healthcare workers. Healthcare workers who received training on hand hygiene were more likely to have good/moderate perception (OR: 3.2, p < 0.05) and to routinely use alcohol-based hand rubs (OR: 3.8, p < 0.05) than the ones without such training. Physicians are more likely (OR: 4.9, p < 0.05) to routinely use alcohol-based hand rubs than technicians. Our research highlighted gaps in hand hygiene knowledge, perception and practice among healthcare workers in Qassim, Saudi Arabia and the importance of training in this regard.

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1193. Assessing Sustainability of Hand Hygiene Adherence 5 Years after a Contest-Based Intervention in 3 Japanese Hospitals

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1056 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S428-S428

Author(s):

Tomoko Sakihama ◽

Naomi Kayauchi ◽

Sanjay Saint ◽

Karen E Fowler ◽

David Ratz ◽

...

Keyword(s):

Hand Hygiene ◽

Direct Observation ◽

Healthcare Workers ◽

Tertiary Care ◽

World Health ◽

Intervention Period ◽

Post Intervention ◽

Multimodal Intervention ◽

Health Organization ◽

Survey Responses

Abstract Background To evaluate the 5-year sustainability of a multimodal intervention which included a prize to the hospital with the highest overall hand hygiene adherence rates among healthcare workers. Methods Design: An observational study using direct observation of hand hygiene adherence performed by a trained observer coupled with a survey of healthcare workers about their knowledge of hand hygiene practices. Setting: Three Japanese tertiary care hospitals. Study Population: Physicians and nurses working on an inpatient medical or surgical ward, an intensive care unit (ICU), or the emergency department. Outcome Measures: Hand hygiene adherence rates before patient contact using unobtrusive direct observation. Secondary outcomes were survey responses on a World Health Organization (WHO) questionnaire on hand hygiene. Results Data for the current study were collected between September and December 2017 at the 3 participating hospitals. An additional 2,485 observations were conducted during this 5-year post-intervention assessment. These observations were compared with 2,679 observations from the pre-intervention period, and 2,982 observations from the 6-month post-intervention period. Hand hygiene adherence rates had previously improved significantly after the introduction of a multimodal intervention – based on principles recommend by the WHO – in 2012 and 2013 in 3 Japanese hospitals (18.0% pre-intervention to 32.7% 6-months post-intervention; P < 0.001). No significant changes were found in hand hygiene adherence in these hospitals 5 years after the original intervention (31.9% 5-years post-intervention; P = 0.53); however, substantial variability in hand hygiene adherence by unit and healthcare worker type was noted. Conclusion A multimodal hand hygiene initiative achieved sustained improvement in hand hygiene adherence in 3 Japanese hospitals 5 years after the original intervention. Disclosures All authors: No reported disclosures.

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Compliance of Healthcare Workers with Hand Hygiene Practices in Neonatal and Pediatric Intensive Care Units: Overt Observation

Interdisciplinary Perspectives on Infectious Diseases ◽

10.1155/2014/306478 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 18

Author(s):

Ayşe Karaaslan ◽

Eda Kepenekli Kadayifci ◽

Serkan Atıcı ◽

Uluhan Sili ◽

Ahmet Soysal ◽

...

Keyword(s):

Intensive Care ◽

Hand Hygiene ◽

Healthcare Workers ◽

Pediatric Intensive Care ◽

University Hospital ◽

World Health ◽

Routine Patient Care ◽

Hygiene Practices ◽

Health Organization ◽

Observation Period

Background.The objective of this study was to assess the compliance of hand hygiene (HH) of healthcare workers (HCWs) in the neonatal and pediatric intensive care unit in a tertiary university hospital in Istanbul.Methods.An observational study was conducted on the compliance of HH for the five World Health Organization (WHO) indications. HCWs were observed during routine patient care in day shift. The authors also measured the technique of HH through hand washing or hand hygiene with alcohol-based disinfectant.Results.A total of 704 HH opportunities were identified during the observation period. Overall compliance was 37.0% (261/704). Compliance differed by role: nurses (41.4%) and doctors (31.9%) [P=0.02, OR: 1.504, CI 95%: 1.058–2.137]. HCWs were more likely to use soap and water (63.6%) compared to waterless-alcohol-based hand hygiene (36.3%) [P<0.05].Conclusion.Adherence to hand hygiene practice and use of alcohol-based disinfectant was found to be very low. Effective education programs that improve adherence to hand hygiene and use of disinfectants may be helpful to increase compliance.

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Handwashing Practices in Neonatal Intensive Care Unit, Paediatric Intensive Care Unit and Neonatal Nurseries in Patan Hospital

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v15i1.18028 ◽

2017 ◽

Vol 15 (1) ◽

pp. 56-60

Author(s):

Suchita Joshi ◽

Puja Amatya ◽

Bibek Poudel ◽

Saroj Adhikari Yadav

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hand Hygiene ◽

Healthcare Workers ◽

Neonatal Intensive Care ◽

World Health ◽

Neonatal Intensive Care Units ◽

Post Intervention ◽

Health Organization ◽

Hospital Acquired

Background: Hand hygiene has been identified as the single most important factor in minimising hospital acquired infections. However, compliance of handwashing guidelines has remained low. The aim of this study was to study the handwashing practices in the Paediatric and Neonatal intensive care units and Neonatal nurseries in Patan Hospital, and secondly to re-evaluate the improvement on compliance of handwashing guidelines after intervention.Methods: Pre-intervention study was conducted by covertly observing the handwashing practices by the healthcare workers. The healthcare workers were then shown the video demonstrating correct methods of handwashing as recommended by World health organization. The cycle was completed by discretely re-observing the handwashing practices following intervention.Results: Sixty five samples were collected initially. Only 6 (9.2%) had completed all steps of handwashing correctly. Post- intervention, 51 samples were collected, out of which 35 (68.6%) had correctly completed all the steps. Following audio-visual demonstration, 100% correctly completed 8/10 steps of handwashing with soap and water. 8 (16%) failed to dry hands using a single use towel and 14 (28%) failed to turn off the tap using elbow. Postintervention, 100% correctly completed 4/7 steps of handwashing using chlorhexidine. Four (15%) still failed to rub backs of fingers to opposite palm, eight (30%) failed to palm to palm with fingers interlaced, and rub thumb to opposite palm.Conclusions: Compliance in hand hygiene is low despite the known fact that it reduces nosocomial infections. However, a simple intervention like video demonstration can improve the compliance among healthcare workers.

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Knowledge, Perception, and Performance of Hand Hygiene and Their Correlation among Nursing Students in Republic of Korea

Healthcare ◽

10.3390/healthcare9070913 ◽

2021 ◽

Vol 9 (7) ◽

pp. 913

Author(s):

Hyang Soon Oh

Keyword(s):

Nursing Education ◽

Clinical Practice ◽

Nursing Students ◽

Hand Hygiene ◽

Healthcare Workers ◽

Final Analysis ◽

World Health ◽

Cross Sectional ◽

And Performance ◽

Health Organization

Recently, various outbreaks of newly emerging or reemerging diseases are expected more frequently and regularly. The importance of hand hygiene (HH) competency of nursing students (NS) is further required as a crucial learning objective of nursing education in universities. Purpose: This study aimed to investigate knowledge, perception, and performance of HH among NS and analyze their correlation. Methods: A cross-sectional questionnaire (modified from a World Health Organization questionnaire) was conducted from 23 November to 22 December 2019; 233 responses were used for the final analysis. Results: The average scores (mean ± standard deviation (range)) for knowledge, perception, and performance of HH were 17.82 ± 2.15 (0–25), 77.24 ± 10.78 (15–96), and 67.42 ± 23.10 (0–100), respectively. No significant variables were discovered to the knowledge of HH. Grade, university-affiliated hospitals, and the most recent healthcare institute of clinical practice nursing course significantly affected perceptions of HH (p < 0.039, p = 044, p < 0.001). Knowledge of HH was positively correlated with performance of HH (p = 0.002). The perception and the performance of HH of NS were positively correlated with HH performance of healthcare workers (HCWs); p < 0.001, p = 0.002. Conclusion: HH education for NS is crucial for improving the performance and the knowledge of HH. Good HH performance of healthcare workers (HCWs) can contribute to increased perception and performance of HH among NS. The cooperation of nursing education in a university and clinical practice with competent HCWs in healthcare institutions may create an effective education program for good HH performance of NS, who will be nurses during unpredictable pandemics.

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Appropriate Number of Observations For Determining Hand Hygiene Compliance Among Healthcare Workers

10.21203/rs.3.rs-659400/v1 ◽

2021 ◽

Author(s):

Se Yoon Park ◽

Suyeon Park ◽

Eunjung Lee ◽

Tae Hyong Kim ◽

Sungho Won

Keyword(s):

Confidence Interval ◽

Hand Hygiene ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Mean Value ◽

World Health ◽

The World ◽

Minimum Number ◽

Hygiene Compliance ◽

Health Organization

Abstract We sought to determine the minimum number of observations needed to determine hand hygiene (HH) compliance among healthcare workers. The study was conducted at a referral hospital in South Korea. We retrospectively analyzed the result of HH monitoring from January to December 2018. HH compliance was calculated by dividing the number of observed HH actions by the total number of opportunities. Optimal HH compliance rates were calculated based on adherence to the six-step technique recommended by the World Health Organization. The minimum number of required observations (n) was calculated by the following equation using overall mean value (r), absolute precision (d), and confidence interval (CI) (1-α) [The equation: n ≥ Z2 α/2 * p * (1-p)/d2 ]. We considered ds of 5%, 10%, 20%, and 30%, with CIs of 99%, 95%, and 90%. During the study period, 8,791 HH opportunities among 1,168 healthcare workers were monitored. Mean HH compliance and optimal HH compliance rates were 80.3% and 59.7%, respectively. The minimum number of observations required to determine HH compliance rates ranged from 2 (d: 30%, CI: 90%) to 624 (d: 5%, CI: 99%), and that for optimal HH compliance ranged from 5 (d: 30%, CI: 90%) to 642 (d: 5%, CI: 99%). We found that at least five observations were needed to determine optimal HH compliance with 30% absolute precision and a 90% CI.

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