Compared hand hygiene compliance among healthcare providers before and after the COVID-19 pandemic: A rapid review and meta-analysis

Abstract

Background Hand hygiene (HH) is a cost-effective measure to reduce healthcare-associated infections. The overall characteristics and changes of hand hygiene compliance (HHC) among healthcare providers during the COVID-19 pandemic provided evidence for targeted HH intervention measures. Aim To systematically review the literature and conduct a meta-analysis of studies investigating the rate of HHC and the characteristics of HH during the COVID-19 pandemic. Methods The PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, VIP and CBM databases were searched. All the original articles with valid HHC data among healthcare providers during the COVID-19 pandemic (from January 1, 2020 to October 1, 2021) were included. Meta-analysis was performed using a DerSimonian and Laird model to yield a point estimate and a 95% CI for the HHC rate. The heterogeneity of the studies was evaluated using the Cochrane Q test and I 2 statistics and a random-effects model was used to contrast between different occupations, the WHO five-moments of HH and different observation methods. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed. Findings Seven studies with 2377 healthcare providers reporting HHC were identified. The estimated overall HHC was 74%, which was higher than that reported in previous studies (5%-89%). Fever clinic has become a new key place for HHC observation. Nurses had the highest HHC (80%; 95% CI:74%–87%) while auxiliary workers (70%; 95%CI:62%–77%) had the lowest. For the WHO five-moments, the healthcare providers had the highest HHC after contact with the body fluids of the patients (91%; 95% CI:88%–94%), while before contact with patients healthcare providers had the lowest HHC (68%; 95% CI:62%–74%) which was consistent with before the pandemic. There existed great HHC differences among different monitoring methods (automatic monitoring system:53%; 95% CI:44%–63% vs openly and secretly observation: 91%; 95% CI: 90%–91%). Conclusions During the COVID-19 pandemic, the compliance of healthcare providers’ HH showed a great improvement. The fever clinics have become the focused departments for HH monitoring. The HHC of auxiliary workers and the HH opportunity for “before contact with patients” should be strengthened. In the future, it will be necessary to develop standardized HH monitoring tools for practical work.

Practice and System Factors Impact on Infection Prevention and Control in General Practice during COVID-19 across 33 Countries: Results of the PRICOV Cross-Sectional Survey

“…Our study has demonstrated that during the COVID-19 pandemic all examined IPC measures improved compared with the situation prior to the pandemic. Previous studies also indicated advances in implementing IPC measures and better IPC compliance among healthcare workers (HCWs), both during COVID-19 [21,22] and other viral outbreaks [23,24]. It is expected that outbreak risk drives positive changes in IPC behaviors of healthcare workers (HCWs) due to fear and heightened awareness of the importance of adhering to IPC guidelines [25].…”

Impact of conducting hand hygiene audit in COVID-19 care locations of India—A large scale national multicentric study – HHAC study

“…The baseline compliance of lower-middle and lower income countries was 29% [ 14 ]. Another systematic review showed the HH compliance from COVID-19 pandemic increased to 74% compared to pre-COVID pandemic studies [ 15 ]. The above compliance rates are comparable with our study.…”

“…A recent systematic review shows that during the pandemic period, nurses had the highest compliance rate of 80% (95% CI, 74%–87%) and auxiliary HCW had the lowest compliance rate of 70% (95% CI, 62%–77%) [ 15 ]. The study from south zone showed profession-specific HHAR was found to be highest among doctors (67.5%) and nurses (66.4%) [ 11 ].…”

Risk stratification for selecting empiric antibiotherapy during and after COVID-19

“…The impact of the pandemic was variable according to structural and organizational factors, and variables associated with the waves of the pandemic. Moreover, the hospital procedures and organization which was specifically set up to address the pandemic, and more specifically the procedures used for the management of COVID-19-related acute respiratory failure (ARF) changed over time, for example, with a decrease in the use of invasive mechanical ventilation [30][31][32][33][34][35][36].…”

“…There is a growing body of evidence suggesting that MDRO-related infections increased in SARS-CoV-2infected patients [85]. This raise, despite a low risk of cross-transmission of colonization related to the lockdown, could be explained by several factors such as an increased antibiotic pressure [86,87], a higher risk of cross-transmission related to overloaded healthcare workers, and by individual specific factors, such as specific procedures (i.e., prone positioning) [85,88], and others such as frequency and duration of exposure to invasive procedures, and immunosuppression [31][32][33].…”