Knowledge, Attitudes, and Perceptions Towards Hand Hygiene of Optometry Students Pre- and Peri-COVID-19 at a Tertiary Institution in Johannesburg, South Africa

Abstract

Purpose Limited research has been completed relating to the knowledge, attitudes and practices (KAP) towards hand hygiene in optometry. The necessity of identifying possible gaps in the cycle of the optometric examination that may have an impact on standard hygiene practices is essential, especially seen in the context of the COVID-19 pandemic. The purpose of the study was to determine if optometry students’ KAP towards hand hygiene changed pre- and peri-COVID-19 to minimize the risk of possible infection it may have for their patients, family, and themselves. Patients and Methods A cross-sectional purposeful sample study was completed among optometry students at a training institution in Johannesburg, South Africa, pre- (2019) and peri-COVID-19 (2022). The WHO hand hygiene knowledge and perception questionnaires for health care workers were adapted and used in the current study. Statistical analyses were performed to test for significant changes between the two groups. Results There was a significant change (p < 0.01) in the use of alcohol-based hand rub (ABHR) in 2022 (87.2%) compared to 2019 (46.5%), although only 41% of students peri-COVID-19 (2022), were aware that a minimum of 20 seconds is required to effectively clean hands. Students, both pre-COVID-19 (63.8%) and peri-COVID-19 (81.8%) perceived performing a hand hygiene regime during an optometric examination to be problematic. A significant peri-COVID-19 (2022) change in perception (p < 0.01) regarding the importance of completing required hand hygiene practices in front of a patient during examination was seen. Conclusion The COVID-19 pandemic provided a unique opportunity to research a possible change in KAP towards hand hygiene practices in optometry students that have not been investigated before. Students were more aware of the impact of hand hygiene practices and the perception thereof, especially by patients and fellow students during the peri-COVID-19 (2022) period. An important finding was the difficulty that students experienced to perform a hand hygiene regime during an optometric examination.

Health Science Students’ Perceptions of Hand Hygiene Education and Practice in a South African University: Introducing the University Hand Hygiene Improvement Model

“…Limited information exists on the impact of hand hygiene education and awareness interventions in South Africa, particularly on changing hand hygiene behaviors among health science students [ 11 , 12 , 13 , 22 , 23 , 24 ]. In previous research, we performed an analytical examination of hand hygiene practices among clinic interns and their patients, utilizing GloGerm™ as a proxy for microbial contaminants, in which we showed that insufficient hand hygiene practices were discernible, based on participants’ hand washing skills after GloGerm™ exposure and their facial expressions and verbal feedback [ 12 ].…”

“…We have highlighted this concern in some of our previous studies and have shown that despite providing university students with hand hygiene education, a significant number of bacterial cells persisted on their hands post-intervention. This discrepancy underscores the need for further exploration of the barriers and facilitators of effective hand hygiene practices within the university setting [ 11 , 24 , 31 ]. The successful implementation of infection control depends critically on two factors: the method’s capability to decrease the pathogen count and the accessibility of the technique to the involved participants.…”

“…Conventional hand hygiene includes washing all surfaces and crevices of the hands with soap and warm water to physically remove dirt and bacteria from the hands [ 4 , 10 , 12 , 24 ]. Hand disinfection (rubbing) involves the use of ABHR or sanitizers by rubbing together all surfaces and crevices of the hands to kill or inactivate microorganisms on the surface of the skin, which does not physically remove them [ 4 , 5 , 12 , 24 , 29 , 34 , 35 , 36 ]. Visibly soiled hands must be handwashed to prevent infection and disease [ 4 , 5 , 9 , 10 ].…”

“…Although HH is a simple and effective infection control strategy and an important barrier in the defence against HAI, a non-compliance rate of 40-70% has been reported in healthcare workers [17][18][19][20][21]. In South Africa, it has been reported that at least one in seven patients visiting South African hospitals are at risk of acquiring an HAI due to poor IPC measures, such as improper waste management and poor handwashing techniques [22,23] Limited information exists on the impact of hand hygiene education and awareness interventions in South Africa, particularly on changing hand hygiene behaviors among health science students [11][12][13][22][23][24]. In previous research, we performed an analytical examination of hand hygiene practices among clinic interns and their patients, utilizing GloGerm™ as a proxy for microbial contaminants, in which we showed that insufficient hand hygiene practices were discernible, based on participants' hand washing skills after GloGerm™ exposure and their facial expressions and verbal feedback [12].…”

“…Hygiene in reference to hand washing and hand disinfection is frequently misrepresented. Conventional hand hygiene includes washing all surfaces and crevices of the hands with soap and warm water to physically remove dirt and bacteria from the hands [4,10,12,24]. Hand disinfection (rubbing) involves the use of ABHR or sanitizers by rubbing together all surfaces and crevices of the hands to kill or inactivate microorganisms on the surface of the skin, which does not physically remove them [4,5,12,24,29,[34][35][36].…”