Rigorous Hand Hygiene Practices Among Health Care Workers Reduce Hospital-Associated Infections During the COVID-19 Pandemic

Abstract

The experiences of these recent months have left us with as many new questions as they have given us new solutions. The main question that infection prevention and control department is having these days is “Why have hospital-associated infections (HAIs) reduced during COVID-19 pandemic?” What is the one unique strategy that has brought decline in increasing HAIs? Would it be appropriate to say that rigorous hand hygiene practices among health care workers (HCWs) have reduced HAIs in a tertiary care hospital of Pakistan? This commentary is written to understand the effect of rigorous hand hygiene among HCWs on number of HAIs during COVID-19 pandemic. Given the seriousness of this outbreak, it was observed that the hand hygiene has occupied a new place of importance in the minds of HCWs. We observed 4 times increase in the consumption of hand sanitizers after COVID-19 outbreak. The increased consumption of hand sanitizers was reflected in improved hand hygiene practices. A reduction was observed in the number of HAIs after the COVID-19 outbreak, and we assume that the dip in HAIs is associated with the improvement in hand hygiene practices in the recent months. In the wake of COVID-19 pandemic, these trends reassure us that hand hygiene compliance by HCWs alone can be effective in reducing HAIs in a hospital setting.

Handwashing with soap: A concern for overuse of water amidst the COVID-19 pandemic in Bangladesh

“…Among all the participants, the mean frequencies of handwashing per day were 2.89 0.23 SD) times and 8.93 5.86 SD) times during pre-pandemic and pandemic situations respectively ( Figure 2 a). This increased rate of handwashing practice during the COVID-19 also coherent with other studies (Amegah, 2020; Roshan et al, 2020 ).

Figure 2 Changes in the behavioral pattern of the participants before and during the COVID-19 with respect to a) mean number of daily handwashes per day (n=1980) and number of handwashes with taps on (n=1134); b) mean duration of hand scrubbing with soap (in sec) before and during COVID-19 (n=1980) and with taps on (n=1134).

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“…The outbreak of Ebola in West Africa in 2014-16 has also raised the demand for clean water for prevention and treatment ( Conversation, 2020 ). Therefore, the frequency of handwashing has also been reported to be increased during the co-current COVID-19 pandemic ( Amegah, 2020 ; Roshan et al, 2020 ). The water demand raised by 20 to 25% in India during this COVID-19 pandemic due to keeping the tap open during handwashing ( Rohilla, 2020 ).…”

The impact of universal face masking and enhanced hand hygiene for COVID-19 disease prevention on the incidence of hospital-acquired infections in a Taiwanese hospital

“…During the COVID-19 crisis, most people have been hyper-aware, especially healthcare workers, about hand hygiene and other infection control activities. Cole and Barnard proposed that COVID-19 has increased the awareness of basic infection control measures and subsequently reduced the incidence of MRDO HAIs ( Cole and Barnard, 2020 , Roshan et al, 2020 ). The increased consumption of hand sanitizers reflected improved hand hygiene practices.…”

Evolution of adherence to hand hygiene in health care professionals in a third level hospital in relation to the SARS-CoV-2 pandemic

“…Resulta preocupante el bajo cumplimiento de la HM, máxime en estos momentos de actualidad de pandemia de SARS-CoV2, pues existen evidencias de intervenciones y recomendaciones relevantes para frenar o reducir la propagación de virus respiratorios a través de una correcta HM [4]. Ello lo confirma el reciente estudio de Virani et al [5], que demuestra que la rutina de la HM es muy eficaz en los protocolos contra el SARS-CoV2.…”

“…La higiene de manos (HM), es decir, cualquier medida adoptada para la limpieza de las manos mediante fricción con un preparado de base alcohólica o lavado con agua y jabón, está ampliamente aceptada como la piedra angular del control de las infecciones relacionadas con la asistencia sanitaria (IRAS) en el entorno hospitalario [3][4][5]. Es conocido que la mayoría de IRAS son transmitidas por contacto directo, especialmente por las manos de los profesionales de la salud [6,7], así como que la adherencia a la HM por parte de aquellos es deficiente, siendo varias las barreras identificadas: irritación producida por los productos y/o la técnica de higiene, inaccesibilidad a los productos, prioridad en atender al paciente antes que en la antisepsia, uso de guantes en vez de antisepsia, olvido, desconocimiento de las recomendaciones, falta de tiempo, alta carga asistencial o falta de información respecto al impacto de la higiene en el control de las IRAS [6,8].…”