Hand Hygiene Practices during the COVID-19 Pandemic in Northern Italy: Assessment of Compliance Rates Measured by Direct Observation and Alcohol-Based Handrub Usage

Vicentini, Costanza; Libero, Giulia; Bordino, Valerio; Zotti, Carla Maria

doi:10.3390/antibiotics11111510

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…In line with previous reports [ 3 , 14 , 16 ], the results of this study highlighted a significant change in hand hygiene practices and AHC in the pandemic period. In particular, this study found a consistent and almost three-fold AHC increase at both the hospital and department levels in 2020, followed by a decrease in 2021.…”

Section: Discussionsupporting

confidence: 92%

“…HH is an essential measure in reducing healthcare associated infections (HAIs) and for preventing the spread of multidrug-resistant organisms (MDRO) [ 1 , 2 ]. Both HAIs and antimicrobial resistance (AMR) are an important risk for patient safety [ 3 ]. Several studies have shown HAIs and AMR increase morbidity, mortality, healthcare costs [ 1 , 4 ], and are associated with a significant burden of disease [ 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…During the pandemic, assessing HH compliance through direct observation proved difficult, as infection prevention and control (IPC) resources were diverged to emergency management, while isolation hindered direct observation. Notwithstanding these difficulties, several studies carried out in acute care hospitals suggest HH compliance increased significantly during the pandemic compared to previous years; however, this trend was not maintained in the longer term [ 3 , 14 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Hand Hygiene and Antimicrobial Resistance in the COVID-19 Era: An Observational Study

et al. 2023

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Hand hygiene (HH) is one of the most important infection prevention and control strategies at the hospital level. The aim of this study was to evaluate the potential COVID-19 pandemic impact on HH practices and rate of healthcare-associated infections. Data on alcohol-based handrub consumption (AHC) and antimicrobial resistance across 27 Italian hospitals over the period 2017–2021 were considered. Data on Methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Enterobacteria (CRE) were extracted from the antimicrobial resistance regional surveillance system. A significant increase was highlighted, with a peak in 2020 and a partial fall in 2021 for AHC (p < 0.001). The decrease in MRSA rates in 2021 compared to 2017–2019 was significant (p = 0.013). A significant Spearman’s correlation between AHC and CRE rates was found (Spearman’s ρ −0.646, p = 0.032). This study supports the importance of AHC monitoring and showed that improving AHC was an attainable goal in the COVID-19 era. However, other strategies are needed to maintain the high levels of AHC attained during the pandemic, in order to avoid a progressive drop that has already begun in 2021. Furthermore, our results support the inverse relationship between AHC and infection rates and antimicrobial-resistant bacteria.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hand Hygiene and Antimicrobial Resistance in the COVID-19 Era: An Observational Study

et al. 2023

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“…A similar observation has been already reported in previous studies for other vaccines ( 30 , 33 – 35 ). Nurses and midwives had a positive change in wearing face-mask than physicians, as previously reported in the literature for hand washing ( 36 ). Instead, HCWs working in Emergency/Critical/Infectious Diseases wards, physicians, and those who need more information about COVID-19 were more willing to accept a vaccine against COVID-19 every year.…”

Section: Discussionsupporting

confidence: 78%

Impact of the COVID-19 pandemic on behavioral changes in healthcare workers in Italy

Sansone,

Miraglia del Giudice,

Della Polla

et al. 2024

Front. Public Health

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IntroductionDuring the COVID-19 pandemic, adherence to wearing face mask and washing hands procedures and achieving high COVID-19 vaccine coverage among healthcare workers (HCWs) were essential to minimize morbidity and possible death and limit the transmission of the virus. The objectives of the cross-sectional survey were to explore the influence of COVID-19 on the use of preventive measures and vaccination willingness among HCWs in the southern part of Italy and the associated factors.MethodsThe survey was carried out from 15 June 2023 to 15 July 2023 among 521 HCWs who worked in three randomly selected public hospitals. All data were collected through a self-administered questionnaire.ResultsHCWs had a positive change in the use of preventive measures if they did not often/always use them before the pandemic, but they are using in the current epidemiologic context and they were willing to use in a future epidemic situation. A positive change in the adherence to face mask-wearing (24.6%) was more likely among those with at least 5 years of university degree, nurses/midwives, and who had worked in COVID-19 wards. A positive change in alcohol-based hand rubbing (3.1%) was more likely in HCWs in Emergency/Critical/Infectious Diseases wards compared with medical wards. HCWs who were more likely to believe that the COVID-19 vaccine should be mandatory for them (58.1%) had at least 5 years of university degree, in Emergency/Critical/Infectious Diseases wards compared with surgical and medical wards, had received more than three doses of this vaccine, were more concerned to get infected during their activity, and had received information from scientific journals. HCWs more willing to receive the COVID-19 vaccine every year (39.8%) were males, physicians, those in Emergency/Critical/Infectious Diseases wards compared with medical wards, who had received more than three doses of this vaccine, who believed that this vaccine should be mandatory for HCWs, and who needed additional information.DiscussionThe survey showed that the COVID-19 pandemic had an impact on the use of preventive measures among HCWs, not necessarily for the improvement or increase. Educational messages on the importance of these measures regarding the promotion and recommendation of the vaccine need to be investigated and applied among HCWs in order to reduce vaccination gaps and the spread of the infection.

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“…Our study recorded higher consumption of the test product compared to other studies [33,40]. The double-blind, randomized, crossover trial of 3 hand rub formulations by Pittet et al reported the mean amount of product used per daily shift was 54.9ml (SD ± 23.5 ml) [33].…”

Section: Discussionsupporting

confidence: 39%

Evaluating the tolerability and acceptability of a locally produced alcohol-based handrub and hand hygiene behaviour among health workers in Sierra Leone: a hospital-based longitudinal intervention study

Fofanah,

Kamara,

Kallon

et al. 2024

Preprint

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Background Alcohol-based handrub (ABHR) is the gold standard for hand hygiene (HH) which 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 hospital-based, longitudinal, interventional study was conducted, adhering to WHO's standardized protocol for evaluating ABHR tolerability and acceptability (Method 1). 60 health workers across 4 hospitals in Sierra Leone were observed over a 30-days period on three separate visits (Day 1, 3–5, and 30) by trained observers. The outcomes of interest included skin tolerability, product acceptability, and HH practice evaluated using subjective and objective measures. Results Objective and subjective evaluations demonstrated strong skin tolerability and high satisfaction with the product. On 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-evaluation on overall skin integrity showed 97% (visit 2) and 98% (visit 3) for scores > 4 (BMS = > 4 in ≥ 75%). Primary acceptability criteria increased up to 95% (colour) and 88% (smell) in visit 3 (BMS = > 4 in ≥ 50%). Despite high acceptability, the product's drying effect remained low at 52% and 58% during visits 2&3 respectively (BMS = > 4 in ≥ 75%). There were positive HH behaviours (n = 53, 88%) with more than half (n = 38, 63%) of them performing HH in almost every HH moment. The mean consumption of ABHR was notably high (76.1ml, SD ± 35), especially among nurses (mean = 80.1ml) and doctors (mean = 74.0ml). 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, while forgetfulness and time constraints were major barriers to HH performance. Further research is recommended to optimize product formulation for skin dryness and investigate the association between ABHR consumption and hand hygiene compliance.

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Hand Hygiene Practices during the COVID-19 Pandemic in Northern Italy: Assessment of Compliance Rates Measured by Direct Observation and Alcohol-Based Handrub Usage

Cited by 7 publications

References 23 publications

Hand Hygiene and Antimicrobial Resistance in the COVID-19 Era: An Observational Study

Hand Hygiene and Antimicrobial Resistance in the COVID-19 Era: An Observational Study

Impact of the COVID-19 pandemic on behavioral changes in healthcare workers in Italy

Evaluating the tolerability and acceptability of a locally produced alcohol-based handrub and hand hygiene behaviour among health workers in Sierra Leone: a hospital-based longitudinal intervention study

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