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Lee YF, Lai WH, Lee PY, Ting SCY, Nuja IA, Ngian HU, Wang J. Acceptability and tolerability of alcohol-based hand rubs among health workers and concessionaires in Malaysia during the COVID pandemic: a hospital-wide cross-sectional study using a modified WHO protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-14. [PMID: 38287203 DOI: 10.1080/09603123.2024.2309324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024]
Abstract
This study evaluated the acceptability and tolerability of three alcohol-based hand rubs (ABHRs) at Sarawak General Hospital, Malaysia. Conducted from 12-26 November 2021 using a modified WHO Protocol, it involved a survey among health workers and concessionaires, with a 35% response rate (1,598 of 4,628 participants). The majority were nurses (60.8%), with the medical division most represented (28.4%). Most respondents (93.2%) used ABHRs at least five days a week and found them easily accessible (72.3%). Product B was the preferred ABHR (65%), primarily for its color and fragrance, surpassing WHO's 50% approval rate in these aspects. However, no other product features met WHO criteria. There were no significant differences in self-reported skin tolerability across the products, and none achieved overall WHO approval. These results offer important insights for ABHR selection in developing countries and highlight the value of the WHO Protocol in assessing product acceptability and tolerability.
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Affiliation(s)
- Yew Fong Lee
- Sarawak General Hospital, Ministry of Health, Kuching, Malaysia
- School of Medical and Life Sciences, Sunway University, Selangor, Malaysia
| | - Wei Hong Lai
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Malaysia
| | - Peh Yee Lee
- Infection Prevention and Control Unit, Sarawak General Hospital, Ministry of Health, Kuching, Malaysia
| | - Samual Chuo Yew Ting
- Pharmaceutical Services Division, Sarawak State Health Department, Ministry of Health, Kuching, Malaysia
| | - Irena Albert Nuja
- Infection Prevention and Control Unit, Sarawak General Hospital, Ministry of Health, Kuching, Malaysia
| | - Hie Ung Ngian
- Hospital Director's Office, Sarawak General Hospital, Ministry of Health, Kuching, Malaysia
| | - Jiancong Wang
- Institute of Biometry and Epidemiology, The German Diabetes Center, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Sowar SF, Acunin R, Cabanalan HC, Abo Arisheh TT, Alkhawaja S. Hand Hygiene Knowledge and Perception Survey for Healthcare Workers in Government Hospitals (GHs) in Bahrain. Cureus 2023; 15:e50126. [PMID: 38186437 PMCID: PMC10771263 DOI: 10.7759/cureus.50126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction and aim Healthcare-associated infections (HAIs) are a serious concern in all healthcare facilities as they may lead to many serious consequences, like prolonged hospitalization, increased mortality and morbidity, and extra costs. Effective hand hygiene (HH) is the primary proven measure known to be effective in reducing the risk of HAIs in all healthcare settings. This study aimed to measure the healthcare workers' (HCWs) knowledge and perception of HH at government hospitals (GHs) in Bahrain. Subjects and methods This cross-sectional study was conducted among HCWs working in GHs in the Kingdom of Bahrain. A self-administered questionnaire was distributed among the targeted population using a Google survey (Google LLC, California, USA). The questionnaire includes socio-demographic data (e.g., age, gender, nationality, etc.) and a validated WHO questionnaire measuring perceptions and knowledge toward HH. Results Of the 285 HCWs, 75.4% were females, and 48.1% were aged between 31 and 40 years old. The overall mean perception was 35.9 (SD 6.93) out of 42 points, with nearly 80% of HCWs considered to have good perception levels. The overall mean knowledge score was 11.4 (SD 1.37) out of 14 points. Accordingly, 75.4% were considered to have good knowledge levels. Factors associated with increased perception include increasing age, female gender, non-Bahraini, being a nurse with increasing years of working experience, and receiving formal training in HH. Being a nurse was the sole significant predictor of increased knowledge. Conclusion The knowledge and perception of HH among HCWs were sufficient. Being a nurse was a significant predictor of both knowledge and perception. Further, a significant positive correlation was noted between the knowledge and perception scores. Maintaining the level of knowledge and perception of HH could lead to improved HH compliance among HCWs.
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Affiliation(s)
- Saleh F Sowar
- Infection Prevention and Control, Government Hospitals, Manama, BHR
| | - Rommel Acunin
- Infection Prevention and Control, Government Hospitals, Manama, BHR
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Moiwo MM, Kamara GN, Kamara D, Kamara IF, Sevalie S, Koroma Z, Kamara KN, Kamara MN, Kamara RZ, Kpagoi SSTK, Konteh SA, Margao S, Fofanah BD, Thomas F, Kanu JS, Tweya HM, Shewade HD, Harries AD. Have Hand Hygiene Practices in Two Tertiary Care Hospitals, Freetown, Sierra Leone, Improved in 2023 following Operational Research in 2021? Trop Med Infect Dis 2023; 8:431. [PMID: 37755893 PMCID: PMC10538178 DOI: 10.3390/tropicalmed8090431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023] Open
Abstract
In 2021, an operational research study in two tertiary hospitals in Freetown showed poor hand hygiene compliance. Recommended actions were taken to improve the situation. Between February-April 2023, a cross-sectional study was conducted in the same two hospitals using the World Health Organization hand hygiene tool to assess and compare hand hygiene compliance with that observed between June-August 2021. In Connaught hospital, overall hand hygiene compliance improved from 51% to 60% (p < 0.001), and this applied to both handwash actions with soap and water and alcohol-based hand rub. Significant improvements were found in all hospital departments and amongst all healthcare worker cadres. In 34 Military Hospital (34MH), overall hand hygiene compliance decreased from 40% to 32% (p < 0.001), with significant decreases observed in all departments and amongst nurses and nursing students. The improvements in Connaught Hospital were probably because of more hand hygiene reminders, better handwash infrastructure and more frequent supervision assessments, compared with 34MH where interventions were less well applied, possibly due to the extensive hospital reconstruction at the time. In conclusion, recommendations from operational research in 2021 contributed towards the improved distribution of hand hygiene reminders, better handwash infrastructure and frequent supervision assessments, which possibly led to improved hand hygiene compliance in one of the two hospitals. These actions need to be strengthened, scaled-up and guided by ongoing operational research to promote good hand hygiene practices elsewhere in the country.
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Affiliation(s)
- Matilda Mattu Moiwo
- Ministry of Defence, Republic of Sierra Leone Armed Forces, Joint Medical Unit, Freetown 00232, Sierra Leone; (G.N.K.); (S.S.)
| | - Gladys Nanilla Kamara
- Ministry of Defence, Republic of Sierra Leone Armed Forces, Joint Medical Unit, Freetown 00232, Sierra Leone; (G.N.K.); (S.S.)
- Department of Clinical Research, Sustainable Health Systems, 34 Military Hospital Research Center, Freetown 00232, Sierra Leone
| | - Dauda Kamara
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (D.K.); (Z.K.); (K.N.K.); (S.S.T.K.K.); (S.M.); (J.S.K.)
| | | | - Stephen Sevalie
- Ministry of Defence, Republic of Sierra Leone Armed Forces, Joint Medical Unit, Freetown 00232, Sierra Leone; (G.N.K.); (S.S.)
- Department of Clinical Research, Sustainable Health Systems, 34 Military Hospital Research Center, Freetown 00232, Sierra Leone
| | - Zikan Koroma
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (D.K.); (Z.K.); (K.N.K.); (S.S.T.K.K.); (S.M.); (J.S.K.)
| | - Kadijatu Nabie Kamara
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (D.K.); (Z.K.); (K.N.K.); (S.S.T.K.K.); (S.M.); (J.S.K.)
| | - Matilda N. Kamara
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (M.N.K.); (F.T.)
| | - Rugiatu Z. Kamara
- United States Centres for Diseases Control and Prevention, Freetown 00232, Sierra Leone;
| | | | | | - Senesie Margao
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (D.K.); (Z.K.); (K.N.K.); (S.S.T.K.K.); (S.M.); (J.S.K.)
| | - Bobson Derrick Fofanah
- World Health Organization Country Office, Freetown 00232, Sierra Leone; (I.F.K.); (B.D.F.)
| | - Fawzi Thomas
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (M.N.K.); (F.T.)
- Pharmacy Board of Sierra Leone, National Pharmacovigilance Centre, Freetown 00232, Sierra Leone
| | - Joseph Sam Kanu
- Ministry of Health and Sanitation, Freetown 00232, Sierra Leone; (D.K.); (Z.K.); (K.N.K.); (S.S.T.K.K.); (S.M.); (J.S.K.)
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 00232, Sierra Leone; (M.N.K.); (F.T.)
| | - Hannock M. Tweya
- International Training and Education Centre for Health, Lilongwe P.O. Box 30369, Malawi;
| | - Hemant Deepak Shewade
- Division of Health Systems Research, ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai 600077, India;
| | - Anthony David Harries
- International Union Against Tuberculosis and Lung Disease (The Union), 2 Rue Lantier, 75001 Paris, France;
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Huang PC, Chien LY, Huang HP. Assessing hand hygiene knowledge, attitude, behavior and adherence among nursing assistants: A cross-sectional study. Geriatr Nurs 2023; 51:232-237. [PMID: 37018849 DOI: 10.1016/j.gerinurse.2023.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE This study explored hand hygiene knowledge, attitude, behaviors and adherence amongst nursing assistants. METHODS This cross-sectional study was conducted with structured questionnaires and direct observation. Nursing assistants were recruited from two long-term care facilities in eastern Taiwan from July to September, 2021. RESULTS The nursing assistants had high levels of hand hygiene knowledge, attitude, and behavior, however, the direct observational revealed hand hygiene adherence at 58.6% with 17.99 seconds duration on average. Comparing with alcohol-based hand rub, the nursing assistants performed very low adherence rate with soap and water wash, and the use of paper towel was the least followed skill applying to soap and water wash. CONCLUSIONS The study finds that hand wash with soap and water has lower adherence than the alcohol-based hand rub. Future innovations in hand hygiene, such as accessible and easy-to-use hand washing agents and easy-to-remember hand cleansing techniques will be valuable.
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Affiliation(s)
- Pei-Chun Huang
- Department of Nursing, Yuanshan Branch, Taipei Veterans General Hospital; Graduate Institute of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Tao-Yuan City 33303, Taiwan
| | - Li-Yu Chien
- Department of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Rd., Gui-Shan Dist., Tao-Yuan City 33303, Taiwan
| | - Hsiang-Ping Huang
- Department of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Rd., Gui-Shan Dist., Tao-Yuan City 33303, Taiwan.
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Hand Hygiene Compliance at Two Tertiary Hospitals in Freetown, Sierra Leone, in 2021: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052978. [PMID: 35270674 PMCID: PMC8910077 DOI: 10.3390/ijerph19052978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 12/04/2022]
Abstract
Hand hygiene actions are essential to reduce healthcare-associated infections and the development of antimicrobial resistance. In this cross-sectional study at two tertiary hospitals, Freetown, Sierra Leone, we observed hand hygiene compliance (defined as using handwash with soap and water or alcohol-based hand rub (ABHR) amongst healthcare workers between June and August 2021. Using the WHO Hand Hygiene tool, observations were made in relation to the type of opportunity, different wards and types of healthcare worker. Overall, 10,461 opportunities for hand hygiene were observed, of which 5086 (49%) resulted in hand hygiene actions. ABHR was used more often than handwash (26% versus 23%, p < 0.001). Overall, compliance was significantly better: after being with a patient/doing a procedure than before (78% after body fluid exposure risk compared with 24% before touching a patient—p < 0.001); in Paediatric (61%) compared with Medical wards (46%)—p < 0.001; and amongst nurses (52%) compared with doctors (44%)—p < 0.001. Similar patterns of compliance were observed within each hospital. In summary, hand hygiene compliance was sub-optimal, especially before being with a patient or before clean/aseptic procedures. Improvement is needed through locally adapted training, hand hygiene reminders in wards and outpatient departments, uninterrupted provision of ABHR and innovative ways to change behaviour.
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Dastyar N, Rafati F, Kamali A, Rafati S, Salari N. Hand hygiene compliance by nurses and midwives during the COVID-19 pandemic: An observational study in Southern Iran. Nurs Midwifery Stud 2022. [DOI: 10.4103/nms.nms_1_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Hand-hygiene-related clinical trials reported between 2014 and 2020: a comprehensive systematic review. J Hosp Infect 2021; 111:6-26. [PMID: 33744382 PMCID: PMC9585124 DOI: 10.1016/j.jhin.2021.03.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/08/2021] [Accepted: 03/08/2021] [Indexed: 12/11/2022]
Abstract
Background There is general consensus that hand hygiene is the most effective way to prevent healthcare-associated infections. However, low rates of compliance amongst healthcare workers have been reported globally. The coronavirus disease 2019 pandemic has further emphasized the need for global improvement in hand hygiene compliance by healthcare workers. Aim This comprehensive systematic review provides an up-to-date compilation of clinical trials, reported between 2014 and 2020, assessing hand hygiene interventions in order to inform healthcare leaders and practitioners regarding approaches to reduce healthcare-associated infections using hand hygiene. Methods CINAHL, Cochrane, EMbase, Medline, PubMed and Web of Science databases were searched for clinical trials published between March 2014 and December 2020 on the topic of hand hygiene compliance among healthcare workers. In total, 332 papers were identified from these searches, of which 57 studies met the inclusion criteria. Findings Forty-five of the 57 studies (79%) included in this review were conducted in Asia, Europe and the USA. The large majority of these clinical trials were conducted in acute care facilities, including hospital wards and intensive care facilities. Nurses represented the largest group of healthcare workers studied (44 studies, 77%), followed by physicians (41 studies, 72%). Thirty-six studies (63%) adopted the World Health Organization's multi-modal framework or a variation of this framework, and many of them recorded hand hygiene opportunities at each of the ‘Five Moments’. However, recording of hand hygiene technique was not common. Conclusion Both single intervention and multi-modal hand hygiene strategies can achieve modest-to-moderate improvements in hand hygiene compliance among healthcare workers.
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Potgieter N, Banda NT, Becker PJ, Traore-Hoffman AN. WASH infrastructure and practices in primary health care clinics in the rural Vhembe District municipality in South Africa. BMC FAMILY PRACTICE 2021; 22:8. [PMID: 33397298 PMCID: PMC7780685 DOI: 10.1186/s12875-020-01346-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 12/07/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND South Africa has unique and diverse social and economic factors that have an impact on the provision of basic water, sanitation, hygiene and waste management infrastructure and practices at health care facilities in ensuring patient safety and prevent the spread of diseases. METHODS The aim of this study was to evaluate water, sanitation and hygiene access and standards at 50 government owned public health care clinics in the rural region of the Vhembe district of South Africa during 2016/2017, using self-observation, an observation checklist, record reviews and interviews with clinic managers. Water quality from all available water sources on the clinic compound was analysed for Total coliform and E. coli counts using the Colilert Quanti-tray/2000 system. The prevalence of pathogenic diarrhea causing E. coli strains was established using multiplex-Polymerase Chain Reaction. RESULTS The health care clinics in the Vhembe District generally complied with the basic WASH services guidelines according to the World Health Organisation. Although 80% of the clinics used borehole water which is classified as an improved water source, microbiological assessment showed that 38% inside taps and 64% outside taps from the clinic compounds had TC counts higher than guideline limits for safe drinking. Similarly, EC counts above the guideline limit for safe drinking water were detected in 17% inside taps and 32% outside taps from the clinic compounds. Pathogenic EAEC, EPEC, ETEC and EHEC strains were isolated in the collected water samples. Although improved sanitation infrastructures were present in most of the clinics, the sanitary conditions of these toilets were not up to standard. Waste systems were not adequately managed. A total of 90% of the clinics had hand washing basins, while only 61% of the clinics had soap present and only 64% of the clinics had adequate signs and posters reminding the staff, care givers and patients to wash their hands. CONCLUSIONS Various WASH aspects within the primary health care system in South Africa needs to be improved and corrected. A more rigorous system that is inclusive of all role players in the WASH sectors, with regular monitoring and training sessions, should be used.
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Affiliation(s)
- N Potgieter
- Department of Microbiology, University of Venda, Thohoyandou, South Africa.
| | - N T Banda
- Department of Microbiology, University of Venda, Thohoyandou, South Africa
| | - P J Becker
- Research Office, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - A N Traore-Hoffman
- Department of Microbiology, University of Venda, Thohoyandou, South Africa
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