RESUMEN
OBJECTIVE: to investigate factors associated with digital health literacy, hand hygiene knowledge and behavior among Brazilian adolescents during the COVID-19 pandemic. METHOD: cross-sectional study with 473 adolescents aged 15 to 19. Data were collected virtually between June and August 2021 through a questionnaire on sociodemographic characteristics, digital health literacy, knowledge and behavior regarding hand hygiene. Variables were adjusted using multiple linear regression models with normal response. RESULTS: the average digital health literacy score was 29.89 ±5.30; for hand hygiene knowledge and behavior was 13.1 ±1.5 and 11.1±2.7, respectively. Higher knowledge and behavior scores for hand hygiene were associated with having completed high school, compared to those attending college, among those who attend health courses, seek information about the pandemic and in scientific articles. Higher digital health literacy scores in adolescents who did not wear masks when playing sports (p= 0.017). There was an association between digital health literacy and knowledge (p = 0.000) and behavior (p = 0.000) regarding hand hygiene. CONCLUSION: there is an association between higher digital health literacy scores and hand hygiene knowledge and behavior.
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COVID-19 , Higiene de las Manos , Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Alfabetización en Salud/estadística & datos numéricos , Adolescente , Estudios Transversales , Femenino , Masculino , Higiene de las Manos/normas , Higiene de las Manos/estadística & datos numéricos , Brasil , Adulto Joven , Encuestas y Cuestionarios , Pandemias , SARS-CoV-2RESUMEN
BACKGROUND: Hand hygiene is known to reduce healthcare-associated infections. However, it remains suboptimal among healthcare providers. In this study, we used the Behaviour-centered Design approach to explore the facilitators and deterrents to hand hygiene among healthcare providers in the Kampala Metropolitan area, Uganda. METHODS: We conducted a formative qualitative study as part of a cluster randomised trial in 19 healthcare facilities (HCFs). The study used 19 semi-structured and 18 key informant interviews to collect data on hand hygiene status and facilitators and deterrents of hand hygiene. Research assistants transcribed verbatim and used a thematic framework aided by Nvivo 14.0. to undertake analysis. We used thick descriptions and illustrative quotes to enhance the credibility and trustworthiness of our findings. RESULTS: About 47.4% of the HCFs had sufficient hand hygiene infrastructure, and 57.9% did not report total compliance with hand hygiene during patient care. The physical facilitator for hand hygiene was the presence of constant reminders such as nudges, while the biological included the frequency of patient contact and the nature of clinical work. The only biological deterrent was the heavy workload in HCFs. The executive brain facilitators included knowledge of workplace health risks, infection prevention and control (IPC) guidelines, and a positive attitude. A negative attitude was the executive brain deterrent to hand hygiene. Recognition, rewards, and fear of infections were the only motivated brain facilitators. Behavioural setting facilitators included proximity to functional hand hygiene infrastructure, the existence of active IPC committees, good leadership, and the availability of a budget for hand hygiene supplies. Behavioural setting deterrents included the non-functionality and non-proximity to hand hygiene infrastructure and inadequate supplies. CONCLUSIONS: The study revealed low compliance with hand hygiene during the critical moments of patient care and inadequacy of hand hygiene infrastructure. The deterrents to hand hygiene included a heavy workload, negative attitude, inadequate supplies, non-functionality, and long distance to hand washing stations. Facilitators included constant reminders, fear of infections, frequency of patient contact and nature of clinical work, positive attitude, knowledge of IPC guidelines, recognition and reward, good leadership, availability of budgets for hand hygiene supplies, availability and proximity to hand hygiene supplies and infrastructure and active IPC committees. TRIAL REGISTRATION: ISRCTN Registry with number ISRCTN98148144. The trial was registered on 23/11/2020.
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Adhesión a Directriz , Higiene de las Manos , Personal de Salud , Investigación Cualitativa , Humanos , Higiene de las Manos/normas , Higiene de las Manos/estadística & datos numéricos , Uganda , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Adhesión a Directriz/estadística & datos numéricos , Femenino , Masculino , Actitud del Personal de Salud , Entrevistas como Asunto , Infección Hospitalaria/prevención & control , AdultoRESUMEN
BACKGROUND: The human hand has constant contact with the environment, hence requires regular hand hygiene. Hand hygiene has gained recognition because of the COVID-19 pandemic and is a largely effective, affordable preventive measure against infectious diseases. This study used both national and sub-national analyses to evaluate the effect of COVID-19 handwashing guidelines on instances of diarrhea in Ghana. METHODS: Data on diarrhea cases spanning February 2018 and March 2022 were retrieved from the District Health Information Management System (DHIMS 2) using a data extraction guide. The data were summarized using descriptive statistics. The difference in diarrhea cases between the pre-COVID-19 and COVID-19 periods was measured using a two-sample t-test across Ghana's 16 administrative areas. Causal Impact package in R statistical software was employed to determine the impact of the introduction of COVID-19 hand hygiene protocols on diarrheal disease. RESULTS: A total of 5,645,533 diarrheal cases reported between February 2018 and March 2022 through the routine MIS (DHIMS2) were examined. Fifty-three percent of the cases occurred before the introduction of the hand hygiene protocol. Descriptive statistics indicated a statistically significant decrease in average diarrheal cases during the hand hygiene implementation era (13,463 cases reduction, p<0.001). Sub-national analyses revealed significant reductions in various regions: Greater Accra, Ashanti, Ahafo, Central, Eastern, Northern, Upper East, Upper West, and Volta (p<0.05). Causal impact analysis confirmed 11.0% nationwide reduction in diarrheal cases attributed to the COVID-19 hand hygiene protocols (p<0.001). CONCLUSION: This study underscores the effectiveness of COVID-19 hand hygiene protocols in reducing diarrheal morbidity in Ghana, with varying regional impacts. These findings advocate for the sustenance of investments and commitments made at the COVID hand hygiene protocols, particularly in this era where the pandemic appears controlled.
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COVID-19 , Diarrea , Higiene de las Manos , Humanos , Ghana/epidemiología , COVID-19/prevención & control , COVID-19/epidemiología , Diarrea/prevención & control , Diarrea/epidemiología , Diarrea/virología , Higiene de las Manos/métodos , Higiene de las Manos/normas , SARS-CoV-2/aislamiento & purificación , Desinfección de las Manos , Pandemias/prevención & controlRESUMEN
BACKGROUND: Infection prevention (IP) behaviors such as hand hygiene (HH) and mobile device disinfection are important to reduce the risk of infection transmission from both family members and hospital staff to critically ill neonates. PURPOSE: To inform the design of educational interventions to improve both patient family and staff IP behaviors, we engaged separate groups of nurses and family members to understand perceptions about the spread of infection and barriers to implementing effective IP strategies. METHODS: This was a qualitative study using focus groups to gather data from neonatal nurses and patient family members. Data were triangulated with hospital-wide survey data and analyzed using inductive content analysis. RESULTS: Twelve nurses and 4 patient family members participated. Themes related to communication about IP between staff and family members emerged: stakeholders expressed discomfort with the timing and nature of just-in-time HH education. These communication challenges contributed to stress levels within the neonatal intensive care unit. This finding was reflected in the hospital-wide survey. IMPLICATIONS FOR PRACTICE AND RESEARCH: Steps should be taken to improve communication about IP behaviors between patient family members and frontline staff. Reducing nurse burden of providing just-in-time HH reminders to patient family members through increased IP education may decrease stress and facilitate IP behaviors. This has the potential to decrease infection spread and improve patient outcomes. The development of interventions targeting stakeholder communication is therefore warranted, but additional research is needed to understand the timing and process for delivery of the educational material.
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Grupos Focales , Control de Infecciones , Unidades de Cuidado Intensivo Neonatal , Investigación Cualitativa , Humanos , Recién Nacido , Control de Infecciones/métodos , Femenino , Higiene de las Manos , Infección Hospitalaria/prevención & control , Masculino , Familia/psicología , Actitud del Personal de Salud , Adulto , Enfermeras Neonatales/psicología , Enfermeras Neonatales/educación , Enfermería Neonatal/métodos , ComunicaciónRESUMEN
Healthcare-associated infections present a challenge to healthcare systems, particularly critical care units. Hand hygiene emerges as a crucial element in infection control, acting as a vital link between healthcare workers, patients, and pathogens. Positive attitudes, motivated by a genuine concern for patient safety, are recognized as major predictors of hand hygiene compliance among healthcare workers. This study aims to assess the attitudes of ICU staff toward hand hygiene and identify factors that influence these attitudes. A cross-sectional survey of intensive care unit staff in seven large Saudi hospitals was conducted using an anonymous, self-reporting questionnaire to examine the attitudes of ICU personnel about hand hygiene and determine the factors that impact these attitudes. A regression analysis was used to determine the determinants of hand hygiene attitudes. Of the 600 respondents, 93% rated their hand hygiene knowledge as good, and 71% received hand hygiene training from their hospital. Most respondents (78%) had previously experienced healthcare-associated infections. The majority reported a favorable overall attitude toward hand hygiene (M = 4.15, SD = 0.85). Attitudes toward hand hygiene were significantly associated with perceived knowledge (ß = 0.32, p < 0.001), prior hand hygiene training (ß = 0.13, p < 0.05), and years of experience (ß = - 0.10, p < 0.05). Healthcare workers in the ICU have a generally positive attitude toward hand hygiene. Such attitudes were correlated with hand hygiene knowledge, prior training, and job experience. The study's findings can help to inform health promotion initiatives and campaigns aimed at achieving long-term improvements in hand hygiene behaviors.
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Actitud del Personal de Salud , Infección Hospitalaria , Higiene de las Manos , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud , Unidades de Cuidados Intensivos , Humanos , Arabia Saudita , Masculino , Femenino , Adulto , Estudios Transversales , Personal de Salud/psicología , Encuestas y Cuestionarios , Infección Hospitalaria/prevención & control , Persona de Mediana Edad , Control de Infecciones/métodosRESUMEN
The number of Methicillin-resistant Staphylococcus aureus (MRSA) cases in communities and hospitals is on the rise worldwide. In this work, a nonlinear deterministic model for the dynamics of MRSA infection in society was developed to visualize the significance of awareness in interventions that could be applied in the prevention of transmission with and without optimal control. Positivity and uniqueness were verified for the proposed corruption model to identify the level of resolution of infection factors in society. Furthermore, how various parameters affect the reproductive number R 0 and sensitivity analysis of the proposed model was explored through mathematical techniques and figures. The global stability of model equilibria analysis was established by using Lyapunov functions with the first derivative test. A total of seven years of data gathered from a private hospital consisting of inpatients and outpatients of MRSA were used in this model for numerical simulations and for observing the dynamics of infection by using a non-standard finite difference (NSFD) scheme. When optimal control was applied as a second model, it was determined that increasing awareness of hand hygiene and wearing a mask were the key controlling measures to prevent the spread of community-acquired MRSA (CA-MRSA) and hospital-acquired MRSA (HA-MRSA). Lastly, it was concluded that both CA-MRSA and HA-MRSA cases are on the rise in the community, and increasing awareness concerning transmission is extremely significant in preventing further spread.
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Infección Hospitalaria , Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Humanos , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/prevención & control , Infecciones Estafilocócicas/microbiología , Prevalencia , Chipre/epidemiología , Infección Hospitalaria/prevención & control , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Infecciones Comunitarias Adquiridas/prevención & control , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/transmisión , Concienciación , Modelos Teóricos , Higiene de las ManosRESUMEN
BACKGROUND: Alcohol-based handrub (ABHR) is the gold standard for hand hygiene (HH) and is a cornerstone of infection prevention and control (IPC) strategies. However, several factors influence the efficient use of ABHR by health workers. This study evaluated the tolerability and acceptability of a locally produced ABHR product and HH behaviour among health workers. METHODS: A longitudinal hospital-based intervention study was conducted in accordance with the WHO's standardized protocol for evaluating ABHR tolerability and acceptability (Method 1). Sixty health workers across 4 hospitals in Sierra Leone were observed over a 30-day period at three separate visits (days 1, 3-5, and 30) by trained observers. The outcomes of interest included skin tolerability and product acceptabilityevaluated using subjective and objective measures. RESULTS: Objective and subjective evaluations demonstrated strong skin tolerability and high acceptability with the product. At all three visits, the skin tolerability score assessed by trained observers was < 2 in ≥ 97% of participants, exceeding the WHO benchmark score (BMS = < 2 in ≥ 75%). Participants' self-evaluations of overall skin integrity were 97% (visit 2) and 98% (visit 3) for scores > 4 (BMS = > 4 in ≥ 75%). The primary acceptability criteria increased up to 95% (colour) and 88% (smell) at visit 3 (BMS = > 4 in ≥ 50%). Despite high acceptability, the product's drying effect remained low at 52% and 58% during visits 2 and 3, respectively (BMS = > 4 in ≥ 75%). There were positive HH behaviours (n = 53, 88%), with more than half (n = 38, 63%) of them exhibiting HH at almost every HH moment. The mean ABHR was notably high (76.1 ml, SD ± 35), especially among nurses (mean = 80.1 ml) and doctors (mean = 74.0 ml). CONCLUSION: The WHO-formulated, locally produced ABHR was well tolerated and accepted by health workers. These findings support the continuous utilization of evidence-based, cost-effective hand hygiene interventions in resource-limited settings. High handrub consumption and frequent HH practices were noticeable HH behaviours. Further research is recommended to optimize product formulations for skin dryness and investigate the association between ABHR consumption and hand hygiene compliance.
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Higiene de las Manos , Humanos , Sierra Leona , Estudios Longitudinales , Femenino , Masculino , Adulto , Higiene de las Manos/normas , Higiene de las Manos/métodos , Personal de Salud , Etanol , Persona de Mediana Edad , Desinfección de las Manos/métodosRESUMEN
The Hazard Analysis and Critical Control Point (HACCP) system plays a crucial role in ensuring food safety within food service establishments, effectively reducing the risk of foodborne diseases. This study focused on assessing the risk of microbe contamination in poultry-based cook-served food during meal preparation in four restaurants and five selected HACCP-certified hotels in eastern China. We examined samples collected from 26 poultry-based cooked dishes, 248 food contact surfaces, 252 non-food contact surfaces, and 121 hand swabs. Our findings indicated a favorable trend of compliance with Chinese national standards, as Escherichia coli and Campylobacter were not detected in any cooked food samples. However, the microbiological assessments revealed non-compliance with total plate count standards in 7 % of the cooked samples from restaurants. In contrast, both dine-in hotels and restaurants exhibited significant non-compliance with guidance concerning food and non-food contact surfaces. Furthermore, our study found that chefs' hand hygiene did not meet microbiological reference standards, even after washing. Notably, Campylobacter persisted at 27 % and 30 % on chefs' hands, posing a significant risk of cross-contamination and foodborne diseases. These findings emphasize the urgent necessity for enhanced supervision of hygiene procedures and process monitoring in the HACCP-certified establishments engaged in the preparation and serving of food. Targeted interventions and food safety education for different chef subgroups can enhance food handling practices and reduce the risk of foodborne diseases in independent food establishments.
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Contaminación de Alimentos , Microbiología de Alimentos , Restaurantes , Restaurantes/normas , China , Humanos , Contaminación de Alimentos/análisis , Contaminación de Alimentos/prevención & control , Análisis de Peligros y Puntos de Control Críticos/métodos , Inocuidad de los Alimentos , Manipulación de Alimentos/normas , Culinaria/normas , Campylobacter/aislamiento & purificación , Animales , Recuento de Colonia Microbiana , Higiene de las Manos/normasRESUMEN
BACKGROUND: Practicing hand hygiene is a cost-effective method to decrease the occurrence of Healthcare-Associated Infections (HAIs). However, despite their simplicity, adhering to hand hygiene methods among healthcare workers (HCWs) can be highly challenging. We aim to examine the factors influencing hand hygiene compliance as perceived by HCWs working in the intensive care units (ICUs) at several major hospitals in Riyadh, Saudi Arabia. METHOD: This qualitative study was conducted by adopting a content analysis to examine the interviews of HCWs who are currently working in the ICUs of various major hospitals located in the capital city of Riyadh, Saudi Arabia. RESULTS: We interviewed 49 HCWs working in ICUs, with an average age of 38 and 8 years of experience. The HCWs comprised doctors (n = 12), anesthesiologists (n = 6), and nurses (n = 31). There were 34 females and 15 males among the participants. Our analysis revealed several factors that impact hand hygiene compliance, including individual, work/environment, team, task, patient, organizational, and management concerns. Several obstacles and possibilities for enhancement have been identified. CONCLUSION: The results of this study would enhance our comprehension of hand hygiene practices and serve as a foundation for creating future strategies and assessment methods to enhance compliance with hand hygiene protocols in ICUs.
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Adhesión a Directriz , Higiene de las Manos , Unidades de Cuidados Intensivos , Investigación Cualitativa , Humanos , Masculino , Femenino , Adhesión a Directriz/estadística & datos numéricos , Adulto , Higiene de las Manos/normas , Higiene de las Manos/estadística & datos numéricos , Arabia Saudita , Infección Hospitalaria/prevención & control , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Actitud del Personal de Salud , Persona de Mediana Edad , Entrevistas como AsuntoRESUMEN
The traditional method of monitoring hand hygiene (HH) based on specific indications does not ensure that HH is performed for all required indications during patient care. This study aimed to compare HH performance rates (HHPRs) based on specific indications versus overall patient care among nurses at a university hospital. The study retrospectively analyzed HH monitoring data for 1398 indications from 543 patients and 190 nurses. Observations were conducted continuously, tracking a single healthcare worker from before patient contact until the end of the contact within a 30-min period. The indication-based HHPR was found to be 89.1%, while the patient-based HHPR was 78.1%. In the context of patient-based HHPR, the lowest rates were observed among nurses in the emergency room (48.3%) and those with less than 1 year of work experience (66.7%). Moreover, the largest discrepancy between indication-based and patient-based HHPR was noted among emergency room nurses with less than 1 year of experience. This significant difference underscores the need for patient-based HH monitoring, particularly for nurses in emergency settings and those with limited experience.
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Higiene de las Manos , Hospitales Universitarios , Humanos , Estudios Retrospectivos , Higiene de las Manos/normas , Higiene de las Manos/métodos , Higiene de las Manos/estadística & datos numéricos , Femenino , Masculino , Adulto , Adhesión a Directriz/estadística & datos numéricos , Adhesión a Directriz/normas , Control de Infecciones/métodos , Control de Infecciones/normas , Persona de Mediana Edad , Enfermeras y Enfermeros/estadística & datos numéricos , Enfermeras y Enfermeros/psicología , Infección Hospitalaria/prevención & controlRESUMEN
The United States needs a paradigm shift in its approach to control infectious diseases. Current recommendations are often made in a siloed feedback loop. This may be the driver for such actions as the abandonment of contact precautions in some settings, the allowance of nursing home residents who are carriers of known pathogens to mingle with others in their facility, and the determination of an intervention's feasibility based upon budgetary rather than health considerations for patients and staff. Data from both the U.S. Veterans Health Administration and the U.K.'s National Health Service support the importance of carrier identification and source control. Both organizations observed marked decreases in methicillin-resistant Staphylococcus aureus (MRSA), but not methicillin-susceptible Staphylococcus aureus infections with the implementation of MRSA admission screening measures. Facilities are becoming over-reliant on horizontal prevention strategies, such as hand hygiene and chlorhexidine bathing. Hand hygiene is an essential practice, but the goal should be to minimize the risk of workers' hands becoming contaminated with defined pathogens, and there are conflicting data on the efficacy of chlorhexidine bathing in non-ICU settings. Preemptive identification of dedicated pathogens and effective source control are needed. We propose that the Centers for Disease Control and Prevention should gather and publicly report the community incidence of dedicated pathogens. This will enable proactive rather than reactive strategies. In the future, determination of a patient's microbiome may become standard, but until then we propose that we should have knowledge of the main pathogens that they are carrying.
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Infección Hospitalaria , Control de Infecciones , Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas , Humanos , Estados Unidos/epidemiología , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Infección Hospitalaria/prevención & control , Infección Hospitalaria/epidemiología , Infecciones Estafilocócicas/prevención & control , Infecciones Estafilocócicas/epidemiología , Pandemias/prevención & control , Centers for Disease Control and Prevention, U.S. , Higiene de las ManosRESUMEN
The use of jewelry among healthcare professionals poses a risk of cross contamination due to potential bacterial accumulation and spread. Through a mixed-method design, this study first analyzed the implications of healthcare professionals wearing jewelry on patient care biosafety as well as on the residual bacterial load of hands and rings after hand hygiene. Firstly, an observational prevalence study to verify whether nursing professionals wear personal accessories during healthcare assistance was carried out. Second, an experimental design involving intentional contamination and hygiene of the hands, with and without a ring, was conducted. The bacterial load of both hands and rings was measured by counting colony forming units. The observational study showed that nursing workers frequently wear jewelry during healthcare assistance. Nonetheless, the experimental study did not indicate differences in bacterial contamination between hands with and without a ring, despite the hand hygiene procedure applied. In conclusion, many nursing workers wear jewelry in the workplace. Although hands with and without a ring exhibited similar microbial load, rings appeared as a potential source of bacterial contamination, reinforcing the need to remove jewelry during working hours. Hand hygiene using alcohol, or soap and water significantly decreased the bacterial load on the participants' hands, with handwashing proving to be the most efficient method for removing intentional contamination.
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Personal de Salud , Joyas , Humanos , Joyas/microbiología , Masculino , Femenino , Adulto , Mano/microbiología , Desinfección de las Manos/métodos , Atención al Paciente , Higiene de las Manos , Persona de Mediana Edad , Carga BacterianaRESUMEN
AIM: Our aim was to conduct a thorough comparison between the hand hygiene information included in international nursing textbooks and the Slovenian nursing textbook's equivalent content as it relates to nursing procedures. BACKGROUND: Hand hygiene practices are crucial in preventing healthcare-associated infections, which affect millions of patients annually. The idea behind "Five Moments for Hand Hygiene" is to encourage assessing success and boosting self-efficacy. DESIGN: Comparison of hand hygiene content in international nursing textbooks with the content in a Slovenian nursing textbook. METHODS: A study was conducted between March 2023 and March 2024 to compare hand hygiene content in international nursing textbooks. The study included textbooks from the USA and UK, as well as Slovenian (SI) textbooks. The final phase involved comparing hand hygiene performance practices against the WHO Five Moments for Hand Hygiene. RESULTS: The study reviewed 470 nursing procedures across three textbooks, identifying four common ones: female indwelling urinary catheterisation, small-bore feeding tube insertion, enema administration and subcutaneous injections. The USA textbook had the highest number of steps, while the UK textbook had the lowest. Clean protective gloves are not recommended for all nursing procedures, only for small-bore feeding tube insertion and enema administration. The US textbook omitted 12 steps for the female indwelling urinary catheter procedure, while the UK textbook included 10 steps. The SI textbook omitted 8 steps. CONCLUSIONS: Hand hygiene is crucial for healthcare infections prevention and control. The study found differences in the frequency of hand hygiene in these nursing procedures. WHO's Five Moments for Hand Hygiene guidelines are not universally accepted, with inadequate hygiene often observed before patient contact. Future research should review foreign textbooks and update existing ones.
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Infección Hospitalaria , Higiene de las Manos , Libros de Texto como Asunto , Humanos , Higiene de las Manos/normas , Reino Unido , Eslovenia , Estados Unidos , Infección Hospitalaria/prevención & control , Control de Infecciones/normas , Control de Infecciones/métodosRESUMEN
OBJECTIVE: To assess the compliance with French guidelines for the prevention of central venous catheter (CVC)-related infections in two university hospitals. METHODS: An observational audit was conducted in 7 wards using a digital tool. RESULTS: The prerequisite of hand hygiene (HH) were respected by 90% of health-care worker; 86% performed HH prior to equipment preparation and 59% repeated it prior to infusion. Wearing gloves when necessary and rinsing were respected in 46.7% and 75.6% of the observations. CONCLUSION: Findings showed an acceptable level of adherence to recommended practices for CVC management. However, barriers of unrespect evidence-based recommendations need to be investigated in depth.
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Infecciones Relacionadas con Catéteres , Cateterismo Venoso Central , Catéteres Venosos Centrales , Adhesión a Directriz , Hospitales Universitarios , Humanos , Francia , Cateterismo Venoso Central/efectos adversos , Adhesión a Directriz/estadística & datos numéricos , Infecciones Relacionadas con Catéteres/prevención & control , Catéteres Venosos Centrales/efectos adversos , Higiene de las Manos/normas , Higiene de las Manos/métodos , Control de Infecciones/métodos , Control de Infecciones/normas , Infección Hospitalaria/prevención & controlRESUMEN
BACKGROUND: Hand hygiene is the most important way to prevent health care-associated infections. It is important for all nurses that come in physical contact with patients the most to follow hand hygiene rules. AIM: This study aimed to determine the relationship between nurses' hand hygiene beliefs and practices and their ethical sensitivity. METHOD: This descriptive and cross-sectional study was conducted with nurses working in internal medicine, surgery and intensive care clinics of a university hospital between June and August 2022. A total of 350 nurses participated in the study. A Personal Information Form, the Ethical Sensitivity Questionnaire (ESQ), the Hand Hygiene Practice Inventory (HHPI), and the Hand Hygiene Beliefs Scale (HHBS) were used for data collection. RESULTS: Findings support that nurses have moderate ethical sensitivity (88.36 ± 26.33), good hand hygiene beliefs (85.60 ± 9.21) and practice (66.14 ± 5.90). Despite there being no statistical significance in evaluating the relationship between hand hygiene practice and ethical sensitivity (p = 0.253, r = -0.061), there was a statically significant inverse relationship between hand hygiene beliefs and ethical sensitivity (p = 0.001, r = -0.172). The hand hygiene compliance score of the nurses who received only ethics training after nursing school (p = 0.000); the hand hygiene belief (p = 0.011) and hand hygiene practice (p = 0.007) scores of those who received both ethics and hand hygiene training were higher. CONCLUSIONS: It can be said that the ethical sensitivity of nurses does not affect their hand hygiene practices, and the hand hygiene and ethics education they receive after school education increases their hand hygiene beliefs and practices.
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Higiene de las Manos , Personal de Enfermería en Hospital , Humanos , Higiene de las Manos/estadística & datos numéricos , Higiene de las Manos/normas , Estudios Transversales , Femenino , Adulto , Masculino , Personal de Enfermería en Hospital/psicología , Personal de Enfermería en Hospital/estadística & datos numéricos , Encuestas y Cuestionarios , Persona de Mediana Edad , Conocimientos, Actitudes y Práctica en Salud , Actitud del Personal de Salud , Adhesión a Directriz/estadística & datos numéricos , Infección Hospitalaria/prevención & control , Adulto JovenRESUMEN
BACKGROUND: Respiratory physiotherapists (RPs) are an integral part of healthcare workers delivering care to intubated patients. Our study aimed to evaluate the effect of awareness campaigns on hand hygiene (HH) compliance among RPs. METHOD: An observational single-center study was conducted between 2015 and 2022 in different ICU types in both adult and paediatric settings. The hand hygiene compliance rates were monitored prospectively and the quality improvement interventions included various hand hygiene campaigns and awareness sessions with RPs. Compliance was calculated as a percentage of events over total opportunities observed. RESULTS: There was a significant increase in compliance rates for all five moments of HH (p-value: <0.05). Overall, mean compliance rate in ICUs was significantly higher than wards for Moment 1 (p-value: 0.0045), Moment 4 (p-value: 0.0372) and Moment 5 (p-value: 0.0036) by 24.2%, 22.7% and 21.5% respectively. Also, paediatric ICUs had higher HH compliance than adult ICUs for Moment 1 (87.5% vs 61.1%; p-value: 0.0459) and Moment 4 (93.7% vs 79.3%; p-value: 0.0255). A significant increase in HH compliance was observed in post-COVID-19 period compared to pre-COVID-19 period with respect to Moment 1, 2 and 5. CONCLUSION: This study adds to the almost non-existent literature on this important category of healthcare workers working in respiratory ICUs. Our results project an increase compliance after the HH awareness programmes over the years among RP which is critical to prevent spread infection by multidrug resistant organisms among the hospitals.
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COVID-19 , Adhesión a Directriz , Higiene de las Manos , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Adhesión a Directriz/estadística & datos numéricos , Higiene de las Manos/estadística & datos numéricos , Higiene de las Manos/normas , Fisioterapeutas/estadística & datos numéricos , SARS-CoV-2 , Unidades de Cuidados Intensivos/estadística & datos numéricos , Personal de Salud/estadística & datos numéricos , Adulto , Estudios ProspectivosRESUMEN
BACKGROUND: Health care-associated infections (HAIs) are a major threat to patient safety and quality care. However, they are avoidable by implementing evidence-based infection prevention and control (IPC) measures. This review evaluated the evidence of the effectiveness of IPC interventions in reducing rates of HAIs in health care settings in Africa. METHODS: We searched several databases: CENTRAL, EMBASE, PUBMED, CINAHL, WHO IRIS, and AJOL for primary studies reporting rates of the 4 most frequent HAIs: surgical site infections, central line--associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumoniae, and increase in hand hygiene compliance. Two reviewers appraised the studies and PRISMA guidelines were followed. RESULTS: Out of 4,624 studies identified from databases and additional sources, 15 studies were finally included in the review. The majority of studies were of pre- and post-test study design. All the studies implemented a combination of interventions and not as stand-alone components. Across all included studies, an improvement was reported in at least 1 primary outcome. CONCLUSIONS: Our review highlights the potential of IPC interventions in reducing HAIs and improving compliance with hand hygiene in health care facilities in Africa. For future research, we recommend more pragmatic study designs with improved methodological rigor.
Asunto(s)
Infección Hospitalaria , Instituciones de Salud , Control de Infecciones , Humanos , Infección Hospitalaria/prevención & control , África , Control de Infecciones/métodos , Control de Infecciones/normas , Instituciones de Salud/normas , Higiene de las Manos/normasRESUMEN
BACKGROUND: Paramedics are exposed to many infectious diseases in their professional activities, leading to a high risk of transmitting infectious diseases to patients in out-of-hospital settings, possibly leading to health care associated infections in hospitals and the community. The COVID-19 pandemic highlighted the importance of infection prevention and control in health care and the role of paramedics in infection control is considered even more critical. Despite this, in many countries such as Australia, research into infection prevention and control research has mainly been focused on in-hospital health care professionals with limited out-of-hospital studies. METHODS: This scoping review was based upon Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Literature on knowledge and awareness of infection prevention and control in paramedics in Australia and other countries was evaluated. RESULTS: Based upon selection criteria applied, six papers were identified for inclusion in this review. In many studies, infection prevention and control was identified as being important, however compliance with hand hygiene practices was low and most studies highlighted the need for more education and training on infectious disease for paramedics. CONCLUSION: Current evidence suggests that paramedics have poor compliance with recommended IPC practices. The profession needs to improve IPC education, training, and culture.
Asunto(s)
Técnicos Medios en Salud , COVID-19 , Control de Infecciones , Humanos , Control de Infecciones/métodos , COVID-19/prevención & control , COVID-19/epidemiología , SARS-CoV-2 , Australia , Higiene de las Manos/normas , ParamédicoRESUMEN
BACKGROUND: As an emerging infectious disease with a heterogenous and uncertain transmission pattern, coronavirus disease 2019 (COVID-19) has created a catastrophe in healthcare-associated infections (HAIs) and posed a significant challenge to infection control practices (ICPs) in healthcare settings. While the unique characteristics of psychiatric patients and clinical settings may make the implementation of ICPs difficult, evidence is lacking for compliance with ICPs among healthcare workers (HCWs) in a psychiatric setting during the COVID-19 pandemic. METHODS: A cross-sectional multi-method study based on participant unobtrusive observation coupled with the completion of a self-administered ICP survey was conducted to assess compliance with ICPs among HCWs in a psychiatric inpatient ward in a regional hospital. An online checklist, called eRub, was used to record the performance of HCWs in hand hygiene (HH) and other essential ICPs. Furthermore, a well-validated questionnaire (i.e., Compliance with Standard Precautions Scale, CSPS) was used to collect the participants' self-reported ICP compliance for later comparison. RESULTS: A total of 2,670 ICP opportunities were observed from January to April 2020. The overall compliance rate was 42.6%. HCWs exhibited satisfactory compliance to the wearing of mask (91.2%) and the handling of clinical waste (87.5%); suboptimal compliance to the handling of sharp objects (67.7%) and linen (72.7%); and poor compliance to HH (3.3%), use of gloves (40.9%), use of personal protective equipment (20%), and disinfection of used surface/area (0.4%). The compliance rates of the nurses and support staff to HH were significantly different (χ2 = 123.25, p < 0.001). In the self-reported survey, the overall compliance rate for ICPs was 64.6%. CONCLUSION: The compliance of HCWs in a psychiatric inpatient ward to ICPs during the COVID-19 pandemic ranged from poor to suboptimal. This result was alarming. Revisions of current ICP guidelines and policies that specifically target barriers in psychiatric settings will be necessary.
Asunto(s)
COVID-19 , Adhesión a Directriz , Personal de Salud , Control de Infecciones , Autoinforme , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Estudios Transversales , Control de Infecciones/métodos , Personal de Salud/psicología , Adhesión a Directriz/estadística & datos numéricos , Encuestas y Cuestionarios , Masculino , SARS-CoV-2 , Femenino , Infección Hospitalaria/prevención & control , Higiene de las Manos/estadística & datos numéricos , Adulto , Persona de Mediana Edad , Servicio de Psiquiatría en Hospital , Equipo de Protección Personal/estadística & datos numéricosRESUMEN
Importance: Few studies have directly and objectively measured the individual and combined effects of multifaceted hand hygiene education programs. Objective: To evaluate the individual and combined immediate effects of an instructional video and hand scan images on handwashing quality, decontamination, and knowledge improvement. Design, Setting, and Participants: This cluster randomized clinical trial was conducted in June to July 2023 among first-year nursing students at a university in Hong Kong. The study used an intention-to-treat analysis. Intervention: Hand hygiene education sessions featuring an instructional video, hand scan images, or both. Main Outcomes and Measures: The primary outcome was the change in residue from fluorescent lotion remaining on participants' hands after handwashing before and after the intervention. The secondary outcomes included handwashing quality and knowledge of hand hygiene. Results: A total of 270 of 280 students (mean [SD] age, 19 [1] years; 182 [67.4%] female) participated in the trial (96.4% participation rate). Participants were randomized to a control group (66 participants), hand scan image group (68 participants), instructional video group (67 participants), and hand scan image with instructional video group (69 participants). All intervention groups had greater reductions in residue after the intervention compared with the control group, although none reached statistical significance (hand scan image group: 3.9 [95% CI, 2.0-5.8] percentage points; instructional video group: 4.8 [95% CI, 2.9-6.7] percentage points; hand scan image with instructional video: 3.5 [95% CI, 1.6-5.4] percentage points; control group: 3.2 [95% CI, 1.3-5.2] percentage points). The instructional video group showed a significant improvement in their handwashing performance, with a higher percentage of participants correctly performing all 7 steps compared with the control group (22.4% [95% CI, 13.1% to 31.6%] vs 1.5% [-7.9% to 10.9%]; P < .001). Hand scan images revealed that wrists, fingertips, and finger webs were the most commonly ignored areas in handwashing. Conclusions and Relevance: In this cluster randomized clinical trial of an education program for hand hygiene, a handwashing instructional video and hand scan images did not enhance the level of decontamination. The intervention group had improved handwashing techniques compared with the control group, a secondary outcome. Trial Registration: ClinicalTrials.gov Identifier: NCT05872581.