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This study investigated the association between area deprivation level and performance of handwashing behavior during the COVID-19 pandemic in Korean adults. This study used data from the 2015 Population and Housing Census data to measure area deprivation level. The 2020 Korea Community Health Survey was used for all other variables, including hand hygiene behavior (August through November 2020). The association between area deprivation level and practice of handwashing behavior was examined using multilevel logistic regression analysis. The study population comprised 215,676 adults aged 19 years or above. Compared to the least area deprived group, the most deprived group was more likely to not wash hands after using the restroom (OR 1.43, 95% CI 1.13-1.82), after coming home (OR 1.85, 95% CI 1.43-2.39), and using soap (OR 1.55, 95% CI 1.29-1.84). The findings suggest the importance of considering area deprivation in implementing policies that promote handwashing, particularly during a pandemic.

Hand hygiene (HH) is the paramount measure used to prevent healthcare-associated infections. A repeated cross-sectional study was undertaken with direct observation of the degree of compliance on HH of healthcare personnel during the SARS-CoV-2 pandemic. Between, 2018-2019, 9,083 HH opportunities were considered, and 5,821 in 2020-2022. Chi squared tests were used to identify associations. The crude and adjusted odds ratios were used along with a logistic regression model for statistical analyses. Compliance on HH increased significantly (p < 0.001) from 54.5% (95% CI: 53.5, 55.5) to 70.1% (95% CI: 68.9, 71.2) during the COVID-19 pandemic. This increase was observed in four of the five key moments of HH established by the World Health Organization (WHO) (p < 0.05), except at moment 4. The factors that were significantly and independently associated with compliance were the time period considered, type of healthcare-personnel, attendance at training sessions, knowledge of HH and WHO guidelines, and availability of hand disinfectant alcoholic solution in pocket format. Highest HH compliance occurred during the COVID-19 pandemic, reflecting a positive change in healthcare-personnel's behaviour regarding HH recommendations.

Background: Many formulations of Alcohol-based hand rubs (ABHRs), such as liquid, gel, and spray have been developed and used for preventing infections. This study aimed to compare skin irritation from using ABHRs in gel and spray formulations., Method: This was a prospective, randomised, crossover trial conducted to investigate the effect of skin irritation caused by ABHRs in gel compared to spray formulation after 21 days of using each formulation. Clinical outcomes were assessed using subjective Larson's skin assessment score and Frosch and Kligman observer skin assessment score, as well as bioengineering measures: transepidermal water loss (TEWL) and skin capacitance on days 3, 7, 14, and 21., Results: Among 38 participants, both formulations showed no significant change in clinical scores and skin capacitance during the study. However, TEWL increased significantly from baseline on day 3 (p = 0.029) for the spray formulation and on day 21 (p = 0.019) for the gel formulation, with no statistically significant difference between the formulations (p = 0.46)., Conclusion: Our research supports the safety of gel and spray ABHRs for regular use, with the only potential issue being mild skin irritation. For those with sensitive skin, the gel formulation is preferable., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Social norm has been found to impact compliance with COVID-19 preventative behaviors, including handwashing, wearing a face mask, social distancing, and cleaning and disinfecting frequently touched surfaces. There is, however, a limited understanding of the social norm influence mechanisms and its boundary condition in the context of COVID-19. Guided by the theory of normative social behaviors (TNSB), this study conducted an online survey ( N  = 336) to examine whether perceived injunctive norms (PIN), outcome expectation (OE), group identity (GID), group orientation (GO), and cultural tightness-looseness (CTL) can moderate and/or mediate the relationship between perceived descriptive norms (PDN) and behavioral intentions (BI) to perform COVID-19 preventative behaviors in the United States. Results showed that whereas OE mediated the PDN-BI relationship to enact all four focal behaviors, PIN mediated the PDN-BI relationship for social distancing, wearing a face mask, and cleaning and disinfecting. However, inconsistent with the predictions, all five moderators (i.e. PIN, OE, GO, GID, and CTL) attenuated, instead of strengthening, the PDN-BI relationships for particular preventative behaviors. Theoretical and practical implications were discussed.

The global emergence of coronavirus disease 2019 (COVID-19) posed unprecedented challenges, jeopardizing decades of progress in healthcare systems, education, and poverty eradication. While proven interventions such as handwashing and mass vaccination offer effective means of curbing COVID-19 spread, their uptake remains low, potentially undermining future pandemic control efforts. This systematic review synthesized available evidence of the factors influencing vaccine uptake and handwashing practices in Kenya, Uganda, and Tanzania in the context of COVID-19 prevention and control. We conducted an extensive literature search across PubMed, Science Direct, and Google Scholar databases following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Out of 391 reviewed articles, 18 were eligible for inclusion. Some of the common barriers to handwashing in Kenya, Uganda, and Tanzania included lack of trust in the government's recommendations or messaging on the benefits of hand hygiene and lack of access to water, while some of the barriers to vaccine uptake included vaccine safety and efficacy concerns and inadequate awareness of vaccination sites and vaccine types. Enablers of handwashing practices encompassed hand hygiene programs and access to soap and water while those of COVID-19 vaccine uptake included improved access to vaccine knowledge and, socio-economic factors like a higher level of education. This review underscores the pivotal role of addressing these barriers while capitalizing on enablers to promote vaccination and handwashing practices. Stakeholders should employ awareness campaigns and community engagement, ensure vaccine and hygiene resources' accessibility, and leverage socio-economic incentives for effective COVID-19 prevention and control. Clinical trial registration : [https://clinicaltrials.gov/], identifier [CRD42023396303]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Muchangi, Mturi, Mukasa, Kithuki, Kosgei, Kanyangi, Moraro and Nankanja.)

Handwashing is an effective public health intervention for preventing the spread of coronavirus (COVID-19). Maintenance of clean hands is particularly important during the pandemic, to break the cycle of human-to-human transmission of the virus. This study explored the potential impact of the COVID-19 pandemic on the handwashing behaviours of residents before and during the pandemic. A mixed-method cross-sectional design using standardised questionnaire was used to examine hand handwashing behaviours among residents before and during the COVID-19 pandemic in the middle belt of Ghana. However, this paper reports on the quantitative data on handwashing behaviour only. A total of 517 participants between 18 to 60 years were randomly selected from the Kintampo Health and Demographic Surveillance System (HDSS) database. Descriptive statistics were performed and McNamar test was used to estimate the difference in the handwashing behaviour of residents. Majority of the respondents were females (54.6%). The majority of them 77.0% (398) usually wash their hands with soap and water. Those who washed hands 4 to 6 times a day before the pandemic increased from 39.9% (159) to 43.7% (174). About 34.8% (180) had received training on hand washing and television 53.3% (96) emerged as the main source of training. Ownership of handwashing facilities increased from 11.4% (59) to 22.8% (118) during the pandemic. The odds of handwashing after handshaking were lower 0.64 (95% C1: 0.44-0.92,) during the pandemic. Television (53.3%) was the main source of training for respondents who had received training on handwashing (34.8%). The odds of owning a handwashing facility during the pandemic were 3 times higher than before (OR = 2.97, 95% CI: 1.94 - 4.65). The odds of handwashing after sneezing were 1.8 (95% CI: 1.19-2.92) times higher during the pandemic. Handwashing behaviours during the pandemic improved among residents than before. However, there is a need to intensify health education and media engagement on proper handwashing practices to protect the population against infectious diseases., Competing Interests: The authors declare no competing interests., (Copyright: Edward Anane Apraku et al.)

Contagious diseases that affect young children place a great burden on them and their families. Proper hand hygiene is an important measure to reduce the disease burden, however, its implementation in day care centres is challenging. This paper introduces a digital intervention to support independent and good handwashing among young children. The intervention leverages animated instructions triggered by water and soap use, together with a symbolic reward shown to children on a screen during and immediately after handwashing. We tested the intervention in a pre-registered, cluster-randomised controlled field trial in 4 day care centres in Finland and Germany with 162 children over 42 days. The intervention increased soaping time, used as a proxy for handwashing quality, by 5.30 s (+ 62%, p < 0.001). The effect occurs immediately at the onset of the intervention and is maintained throughout the intervention phase., (© 2024. The Author(s).)

Poor water sanitation and hygiene is a public health problem in developing and underdeveloped countries, including Ethiopia, and remains an important public health issue among primary school students. Students have been repeatedly exposed to various communicable diseases associated with water sanitation and hygiene. The objective of this study was to assess predictors of handwashing practice among second-cycle public primary school students in East Dembiya District, northwestern Ethiopia, 2022. A cross-sectional study was conducted among 752 second-cycle primary school students. Data were gathered through face-to-face interviews using a structured interviewer-administered questionnaire and observational checklists adopted and modified from different sources of literature. The data were checked further by visualizing and computing rates with the SPSS version 26 statistical software. Multivariable logistic regression was used to identify predictors. The prevalence of washing practices among second-cycle primary school students was 57.6% (95% CI 53.90-61.10). Residency (urban) (adjusted odds ratio [aOR] = 2.17, 95% CI: 1.30-2.87), access to media (aOR = 1.66, 95% CI: 1.11-2.49), hygiene and sanitation club membership (aOR = 1.88, 95% CI: 1.26-2.80), good knowledge about handwashing (aOR = 3.93, 95% CI: 2.34-6.60), and a positive attitude toward handwashing (aOR = 3.63, 95% CI: 2.01-5.584) were predictors of handwashing practice among second-cycle primary school students. This study showed that handwashing practice among primary school students was low. Availing handwashing facilities, better media access, formation of a hygiene and sanitation club in the school, celebration of "Handwashing Day" with students, and leading behavior change communication are all important for improving students' handwashing practice.

Respiratory tract infections (RTIs) have increasingly been reported as a challenging issue for school administration resulting in student absence and/or disseminated contagious pathogens. The present study aimed to characterize the knowledge and preventive measures of the respiratory tract infectious diseases in Tikrit City (Iraq). A total of 200 male/female secondary school students enrolled in the present study. A questionnaire was prepared and directed toward assessing student knowledge regarding disease symptoms and prevention knowledge. The students' knowledge regarding symptoms was graduated in order of high to low starting with a cough (71.7%), sneezing (63.1%), difficulty of breathing (55.1%), Running nose (rhinorrhoea) (65.2%), chest pain (41.9%), muscle pain (myalgia) (40.4%), and joint pain (arthralgia) (40.9%). The preventive measures of ARTIs were recognized by students ranging in order from using a face mask (87.6%), Proper hand washing several times daily (83.4%), Good aeration (80.3%), Vaccination (79.3%), Elimination by paper tissue (77.2%), Avoid contact with infected persons (68.9%), to avoiding crowded area (66.3%). The secondary school students in Tikrit City had generally good knowledge with a good practice and a positive attitude toward prevention (RTIs) in family planning. Hence, the results highlight the important measured parameters providing a clue for the local health authorities in their awareness campaigns.

Background: Compliance with the recommended 30 s drying time of alcohol-based hand rub (ABHR) is often suboptimal. To increase hand hygiene compliance at a neonatal intensive care unit (NICU), we installed an Incubator Traffic Light (ITL) system which shows 'green light' to open incubator doors after the recommended drying time., Aim: To measure the impact of this visual feedback system on NICU healthcare professionals' compliance with the recommended ABHR drying time., Methods: Ten traffic light systems were installed on incubators at a NICU, five of which provided visual feedback, and five, serving as a control group, did not provide visual feedback. During a two-month period, the systems measured drying time between the moment of dispensing ABHR and opening the incubator's doors. The drying times of the incubators were compared with and without feedback., Findings: Of the 6422 recorded hand hygiene events, 658 were valid for data analysis. Compliance with correct drying time reached 75% (N = 397/526) for incubators equipped with visual feedback versus 36% (N = 48/132; P < 0.0001) for incubators lacking this feature., Conclusion: The ITL improves compliance with the recommended 30 s ABHR drying time in a NICU setting., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Hand hygiene (HH) is challenging in health care, but particularly in resource-limited settings due to a lack of training, resources, and infrastructure. This study aimed to evaluate the implementation of wall-mounted alcohol-based handrub (ABHR) at the point of care (POC) on HH compliance among health care workers in a Cameroon hospital., Methods: It was a three-stage before and after study. The first stage involved baseline collection of ABHR utilization and HH compliance data. The second stage included the implementation of ABHR at the POC, supported by an implementation strategy involving HH training, monitoring and feedback, and HH champions. The third stage involved postimplementation data collection on ABHR use and HH compliance., Results: 5,214 HH opportunities were evaluated. HH compliance significantly increased from 33.3% (baseline) to 83.1% (implementation stage) (P < .001) and to 87.2% (postimplementation stage) (P < .001). Weekly ABHR usage increased significantly during implementation (5,670 ml), compared to baseline, (1242.5 ml, P = .001), and remained high in postimplementation (7,740 ml)., Conclusions: Continuous availability of ABHR at POC, supported by implementation strategy, significantly increased HH compliance and ABHR use. Learning from this study could be used to implement ABHR at POC in other facilities., (Copyright © 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Wash'Em is a process that supports humanitarians in assessing and designing rapid but context-specific hygiene programmes in crises or outbreaks. The process consists of training implementers, using tools to learn from populations, and entering findings into a software which generates contextualised activities. A process evaluation of Wash'Em use was conducted in a drought-affected area in Midland province, Zimbabwe. Data were collected during the programme design and following implementation using a mix of qualitative methods. Findings were classified against the intended stages of Wash'Em, and the evaluation domains were defined by the UKRI Medical Research Council. The Wash'Em process was not fully implemented as intended. An abridged training was utilised, some of the tools for learning from populations were omitted, many of the recommended activities were not implemented, the delivery modalities were different from intended, the budget available was minimal, and the number of people exposed to activities were fewer than hoped. Despite these 'on the ground' challenges and adaptations, the Wash'Em process was considered feasible by implementers and was seen to be less top-down than most programme design approaches. The populations exposed to the intervention found the activities engaging, understood the content, and reportedly took action to improve handwashing behaviour. Programmes such as Wash'Em, which facilitate community participation and are underpinned by theory and evidence, are likely to yield positive results even if processes are followed imperfectly., Competing Interests: T.H. and S.W. were involved in the design of the Rapid Assessment Tools and Wash&rsquo;Em Software. A.P.N., E.Z., and T.H. work within Action Contre la Faim, which was one of the subjects of this process evaluation. All other authors declare no competing interests.

Family caregivers are essential inpatient pediatric care partners, yet their handwashing knowledge and compliance are rarely studied. Through hand hygiene audits and self-administered questionnaires, we observed 9% compliance, significantly lower than self-reported practice. We suggest interventions to improve caregiver handwashing behaviors to decrease infection transmission risk to hospitalized children.

This study examined the magnitude and predictors of hand hygiene compliance among 325 healthcare workers in three public hospitals of Northeastern Ethiopia using standardized observational tool. A multivariable logistic regression analysis was computed to identify factors associated with non-compliance. The overall proportion of observed hand hygiene non-compliance was 41.8% (95%CI: 36.6-48.1). Having <5 years of work experience (AOR = 1.5; 95%CI: 1.2-2.5), absence of hand washing soap (AOR = 3.1; 95%CI: 2.3-5.4), work overload (AOR = 2.5; 95%CI: 1.9-4.1), pipe water supply interruption (AOR = 2.8; 95%CI: 2.1-4.9), lack of hand hygiene training (AOR = 3.1; 95%CI: 2.2-4.4), and absence of infection prevention committee (AOR = 2.1; 95%CI: 1.5-4.9) were determinant factors for hand hygiene non-compliance. Therefore, regional health bureau and hospitals' managers should work towards the provision of regular hand hygiene trainings, uninterrupted piped water supply, hand washing soap, and establishment of functional infection prevention committee. Moreover, healthcare workers should be also committed to comply with hand hygiene.

Objective: We investigated gender differences in psychosocial determinants that affect hand hygiene (HH) performance among physicians., Design: The survey included a structured questionnaire with 7 parts: self-assessment of HH execution rate; knowledge, attitude, and behavior regarding HH; internal and emotional motivation for better HH; barriers to HH; need for external reminders; preference for alcohol gel; and embarrassment due to supervision., Setting: The study was conducted across 4 academic referral hospitals in Korea., Participants: Physicians who worked at these hospitals were surveyed., Methods: The survey questionnaire was sent to 994 physicians of the hospitals in July 2018 via email or paper. Differences in psychosocial determinants of HH among physicians were analyzed by gender using an independent t test or the Fisher exact test., Results: Of the 994 physicians, 201 (20.2%) responded to the survey. Among them, 129 (63.5%) were men. Male physicians identified 4 barriers as significant: time wasted on HH ( P = .034); HH is not a habit ( P = .004); often forgetting about HH situations ( P = .002); and no disadvantage when I do not perform HH ( P = .005). Female physicians identified pain and dryness of the hands as a significant obstacle ( P = .010), and they had a higher tendency to feel uncomfortable when a fellow employee performed inadequate HH ( P = .098). Among the respondents, 26.6% identified diversifying the types of hand sanitizers as their first choice for overcoming barriers to improving HH, followed by providing reminders (15.6%) and soap and paper towels in each hospital room (13.0%)., Conclusion: A significant difference in the barriers to HH existed between male and female physicians. Promoting HH activities could help increase HH compliance.

Frequency of hand disinfection and adverse skin reactions among health care workers dramatically increased since the COVID‐19 outbreak and consensus recommendations on hand hygiene were presented. The aim of the present study was to check the efficacy of the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on Contact Dermatitis (CD) recommendations in a real life and to search if providing products mentioned in that recommendations may increase its efficacy. Doctors and nurses who worked with patients during COVID‐19 pandemic and use hand disinfectants received adopted recommendations of the EADV TF on CD only or together with mentioned in that recommendations gel with ethanol and glycerin and emollient. Prevalence of adverse skin reactions on hand disinfectants at baseline was 80.21%. In a month significant improvement of health‐related quality of life (HRQoL) and self‐assessed improvement of hand skin (P <.01 for both) was reported in "products" group only. Number of participants that had no impact on their HRQoL became higher and the Dermatology Life Quality Index scores lower than in "recommendations only" group (P =.03 and P =.02, respectively). Our results showed that recommendations of the EADV TF on CD may significantly improve HRQoL and hand skin status in health care professionals but provision with products mentioned in that recommendations is crucial. [ABSTRACT FROM AUTHOR]

Abstract Background To prevent cross infection the surgical team perform preoperative hand disinfection before dressed in surgical gowns and gloves. Preoperative hand disinfection does not make hands sterile and the surgical glove cuff end has been regarded as a weak link, since it is not a liquid-proof interface. The aims were to investigate if there were differences in bacterial growth and recolonization of hands between operating room nurses and non-health care workers as well as to investigate if bacterial growth existed at the surgical glove cuff end during surgery. Methods This pilot project was conducted as an exploratory comparative clinical trial. Bacterial cultures were taken from the glove and gown interface and at three sites of the hands of 12 operating room nurses and 13 non-health care workers controls directly after preoperative hand disinfection and again after wearing surgical gloves and gowns. Colony forming units were analysed with Mann-Whitney U test and Wilcoxon Sign Ranks test comparing repeated measurements. Categorical variables were evaluated with chi-square test or Fisher’s exact test. Results Operating room nurses compared to non-health care workers had significant higher bacterial growth at two of three culture sites after surgical hand disinfection. Both groups had higher recolonization at one of the three culture sites after wearing surgical gloves. There were no differences between the groups in total colony forming units, that is, all sampling sites. Five out of 12 of the operating room nurses had bacterial growth at the glove cuff end and of those, four had the same bacteria at the glove cuff end as found in the cultures from the hands. Bacteria isolated from the glove cuff were P. acnes, S. warneri, S. epidermidis and Micrococcus species, the CFU/mL ranged from 10 to 40. Conclusions There were differences in bacterial growth and re-colonization between the groups but this was inconclusive. However, bacterial growth exists at the glove cuff and gown interface, further investigation in larger study is needed, to build on these promising, but preliminary, findings. Trial registration Trial registration was performed prospectively at Research web (FOU in Sweden, 117,971) 14/01/2013, and retrospectively at ClinicalTrials.gov (NCT02359708). 01/27/2015.

The aim of this study was to measure the frequency of nosocomial infections in the internal medicine observation units of the emergency services in two level III hospitals in Lima. A 5-day prevalence study was carried out on patients admitted after a 72 hours observation period, in whom community-based infections were ruled out. Data was obtained from clinical records. Additionally, overcrowding and ventilation in the hospitalization rooms were evaluated. The frequency of nosocomial infections in the emergency services was found to be 8.1%, four times what was reported as period prevalence in Peru. The associated risk factors were prolonged length of stay and lack of proper ventilation in the hospital environment. Inadequate ventilation triples the risk of nosocomial infections. [ABSTRACT FROM AUTHOR]

Background: training on hand hygiene is the most widely used strategy to improve the percentage of fulfillment with the instructions in this regard. Objective: to describe the results of the training in hand hygiene developed by the Safe Hands project, prior to COVID-19 in the Cienfuegos municipality. Methods: retrospective descriptive study that gader training activities on hand hygiene developed in day care centers and schools in the Cienfuegos municipality as part of the Safe Hands project. Results: training in hand hygiene in the Cienfuegos municipality allowed the knowledge of the correct technique to be brought to 120 children from day care centers, 169 children from primary schools and 140 adolescents from basic secondary education. A total of 1,356 workers from different sectors, and 411 health workers were trained. Conclusions: the training developed improved the knowledge and skills on hand hygiene among the participants, an extremely important fact to face subsequent events, since hand washing has been one of the main measures to avoid spreading COVID-19 to other people. [ABSTRACT FROM AUTHOR]

Background: Recent studies have proposed that handwashing can lead to the development of allergic disease by reducing skin epithelial barrier integrity. The purpose of this study was to evaluate the association between personal hygiene practices and allergic rhinitis (AR) in a nationally representative sample of Korean adolescents. Methods: A total of 62,276 adolescent participants (aged 12 to 18 years) were analyzed using the Korea Youth Risk Behavior Web‐based Survey, which was conducted in 2017. Participants were asked about the frequency of handwashing considering 5 situations. AR histories throughout life and in the last 12 months were obtained. The associations between AR and hygiene scores were analyzed using multiple logistic regression, with adjustment for possible confounders. Subgroup analyses were conducted for school level, age, economic level, and education level of each parent. Results: The analysis of the general characteristics showed that younger age, increased number of days of physical activity, male sex, living in a large city, high economic level, high education levels of father and mother, nonsmoking status, and no alcohol consumption were associated with a relatively high hygiene score (p < 0.001). The adjusted odds ratio (aOR) of AR was 1.12 (95% confidence interval [CI], 1.06 to 1.18; p < 0.001) throughout life and 1.21 (95% CI, 1.14 to 1.29; p < 0.001) for the previous 12 months in the highest compared with the lowest hygiene score groups. Consistent results were obtained in the female sex, any school level, middle economic level, and both parents with any education level. Conclusion: The association between high hygiene scores and AR was significant in Korean adolescents after adjustment for several variables. [ABSTRACT FROM AUTHOR]

The primary role of personal protective equipment (PPE) within the healthcare environment is to either protect the patient from the healthcare worker or the healthcare worker from the patient. Both patients and carers can be vectors of infectious disease. Hospitals and other healthcare institutions need to protect frontline workers such as healthcare assistants and their patients from infections such as COVID-19 . [ABSTRACT FROM AUTHOR]

Background: The routine use of topical iodinated antiseptic could be a possible cause of iodine contamination. This study was aimed to determine urinary iodine status of operation-room staff who routinely use iodine-containing antiseptics for cleansing of the hands after salt iodization. Materials and methods: The study included 40 operation-room staff who use surgical hand-scrub solutions. Participants applied an iodized brush for a minimum of three times a day on weekdays and were iodine-free on the weekends. Morning urine samples from all volunteers to analyze the urinary iodine concentration (UIC) twice a week. Modified microplate method of Sandell-Kolthoff reaction used to measure UIC. Results: The UICs were significantly higher on Friday (median 194 μg/L (70–396 μg/L)) compared to the Monday concentrations (median 125 μg/L (62–264 μg/L), p < 0.001). Mild iodine deficiency occurred in 32.5% of the subjects on Monday, in 5% on Friday. On Monday, there were no subjects with UIC > 300 μg/L, but on Friday, 7.5% of the subjects had UIC > 300 μg/L. Conclusion: Despite both the use of iodized antiseptic solution and mandatory iodization, operation-room staff had only median iodine levels with low risk of iodine intoxication. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Disinfection is one of the important methods for preventing and controlling of COVID 19. For this reason this "Manual of procedures for cleaning and disinfecting surfaces" is proposed, aimed at systematizing actions in homes, equipment, transport, roads and places of public access in the urban environment to guarantee adequate levels of protection for the population's health. [ABSTRACT FROM AUTHOR]

Infections affect hundreds of millions of people worldwide and it is a major global problem for patient safety. Proper hand washing becomes vitally important to decrease the possibility of infection transmission by medical and nursing personnel. For these reasons, this paper aims to comment on the main theoretical elements that justify that proper hand washing prevents nosocomial infections. It was concluded that washing hands after contact with patients is an obstacle to bacterial spread, especially from one patient to another, and therefore prevents nosocomial infections, so common in our hospitals. [ABSTRACT FROM AUTHOR]

• Hand hygiene is a key component of any infection prevention program. • Ward mangers play an important role implementing strategies to promote hand hygiene but little is known about how they go about this aspect of their work. • This study demonstrates that ward managers could identify many of the issues currently emerging as important in contemporary hand hygiene practice and research and adapted organizational strategies to meet ward needs. • These views should be represented when hand hygiene guidelines are reviewed and updated. Frontline managers promote hand hygiene standards and adherence to hand hygiene protocols. Little is known about this aspect of their role. Qualitative interview study with frontline managers on 2 acute admission wards in a large National Health Service Trust in the United Kingdom. Managers reported that hand hygiene standards and audit were modeled on World Health Organization guidelines. Hand hygiene outside the immediate patient zone was not documented but managers could identify when additional indications for hand hygiene presented. They considered that audit was worthwhile to remind staff that hand hygiene is important but did not regard audit findings as a valid indicator of practice. Managers identified differences in the working patterns of nurses and doctors that affect the number and types of hand hygiene opportunities and barriers to hand hygiene. Ward managers were accepted as the custodians of hand-hygiene standards. Frontline managers identified many of the issues currently emerging as important in contemporary infection prevention practice and research and could apply them locally. Their views should be represented when hand hygiene guidelines are reviewed and updated. [ABSTRACT FROM AUTHOR]

Aim: Health care–associated infections along with antibiotic resistance are a leading risk for patient safety in intensive care units. Hygienic hand disinfection is still regarded as the most effective, simplest, and most cost‐effective measure to reduce health care–associated infections. To improve hand hygiene compliance and to prevent health care–associated infections, interventions of the "German Clean Hands Campaign" were implemented in a university hospital. Methods: Observational single‐center study using direct observation and feedback. Hand hygiene performance was assessed in 12 intensive care units between 2013 and 2017. Linear mixed model regression analyses were used to estimate the compliance trend over time. Results: In total, 10 315 "my five moments for hand hygiene" were observed. The mean hand hygiene compliance rates increased from 75.1% to 88.6% during the study period, yielding an estimated increase of about 4.5% per year. However, there are differences in compliance between occupational groups (physicians: between 61.2% and 77.1%; nurses: between 80.2% and 90.9%; others: between 61.3% and 82.4%). Conclusions: After implementation of the "German Clean Hands Campaign" interventions, an overall significant improvement of hand hygiene was detected. Compliance measurements helped to raise awareness among health care professional groups. SUMMARY STATEMENT: What is already known about this topic? A significantly higher prevalence of infections has been observed in intensive care unit patients compared with patients in other wards.Hygienic hand disinfection is still regarded as the most effective, simplest, and most cost‐effective measure to reduce health care–associated infections.Low hand hygiene rates in intensive care units are a major problem for patient safety. What is already known about this topic? Implementation of the "German Clean Hands Campaign" showed continuous improvement in hand hygiene for all health care professionals in intensive care units over a period of 5 years.There are differences in compliance rates between health care profession and intensive care unit types.Pediatric intensive care units had the highest hand hygiene compliance rates. The implications of this paper: Overall, hand hygiene compliance in intensive care units increased over a period of 5 years after continuous campaigning, training, observation, compliance measurements, and direct feedback.It is necessary to raise awareness for hand hygiene in a repetitive manner within all health care professional groups now and in the future.Because of the differences in compliance rates between health care professionals, more tailored and evidence‐based interventions should be implemented. [ABSTRACT FROM AUTHOR]

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Introduction: Although hand hygiene is the most important measure for biological risk mitigation in hospital settings, there is scientific evidence of low compliance among healthcare workers with the established recommendations. Objective: To assess compliance with five dimensions that strengthen the hand hygiene strategy for biological risk prevention in healthcare settings. Method: Observational, cross-sectional study in five institutions providing healthcare services with the application of descriptive statistics. The Median Test evaluated whether there were significant differences among groups of professionals per health institution, considering a p ≤ 0.05 to be significant. The analysis was completed with a discriminant analysis. Results: First-level hospital institutions showed representative results where the nursing staff, followed by physicians, had a better compliance with the handwashing protocol. This percentage was impacted by the lower compliance with the provisioning of supplies and infrastructure. There is a perfect differentiation between the results of the municipality of Cali compared those of Caicedonia, and in contrast with the results of Popayán, Buga, and Buenaventura. Conclusion: Compliance with the hand hygiene protocol was seen, with an assessment rated as unacceptable for the factors related to supplies and infrastructure and hand hygiene technique. [ABSTRACT FROM AUTHOR]

BackgroundSerial interventions are often used to reduce the risk of health care-associated methicillin-resistant Staphylococcus aureus (MRSA) infections. To our knowledge, the relative impact of these interventions has not previously been ascertained.MethodsWe conducted a retrospective study of 4 major infection control interventions using an interrupted time series design to evaluate their impact on MRSA bacteremia in an 800-bed hospital with 8 intensive care units (ICUs). Interventions were introduced 1 at a time during a 9-year period and involved the promotion of compliance with maximal sterile barrier precautions during central venous catheter placement, the institution of alcohol-based hand rubs for hand disinfection, the introduction of a hand hygiene campaign, and the institution of routine nares surveillance cultures for MRSA in all ICUs for patients on ICU admission and weekly thereafter while in the ICU. Positive cultures resulted in the initiation of contact isolation precautions. Using segmented regression analyses, we evaluated changes in monthly incidence and prevalence of MRSA bacteremia from their predicted values. Methicillin-susceptible Staphylococcus aureus bacteremia was monitored as a control.ResultsRoutine surveillance cultures and subsequent contact isolation precautions resulted in substantial reductions in MRSA bacteremia in both ICUs and non-ICUs. In 16 months, the incidence density of MRSA bacteremia decreased by 75% in ICUs (P=.007) and by 40% in non-ICUs (P=.008), leading to a 67% hospital-wide reduction in the incidence density of MRSA bacteremia (P=.002). Methicillin-susceptible S. aureus bacteremia rates remained stable during this time. The other interventions were not associated with a statistically significant change in MRSA bacteremia.ConclusionsRoutine surveillance for MRSA in ICUs allowed earlier initiation of contact isolation precautions and was associated with large and statistically significant reductions in the incidence of MRSA bacteremia in the ICUs and hospital wide. In contrast, no similar decrease was attributable to the other infection control interventions.

Abstract Background Hand hygiene has evolved over the last decades and many terminologies emerged. We aimed to analyse the evolution in the frequency of utilization of key hand hygiene terms in the literature along the years. Methods We identified keywords and Medical Subject Headings (MeSH) used in MEDLINE® indexation related to hand hygiene by searching international guidelines and the MeSH database. We performed a MEDLINE® search combining the selected keywords and MeSH and analysed the number of publications retrieved yearly. Results The literature search yielded 9019 publications when all hand hygiene related search terms were combined, between 1921 and November 2016. The total number of publications per year increased from a median of 4 (IQR 3, 6) in the 1950’s to 554 (IQR 478, 583) between 2011 and 2015. The most frequently used keywords are hand disinfection, hand hygiene, hand washing, handrub, hand sanitizer and alcohol-based hand rub (ABHR). Until the 1990s, hand disinfection and hand washing were the most frequently used terms. Whilst the last decade has seen a remarkable increase in publications mentioning hand disinfection and hand hygiene and for the first time handrub, hand sanitizers and ABHR were introduced in the literature. Hand disinfection, hand hygiene and hand sanitizers are the main MeSH used by MEDLINE®. Since 2013 hand hygiene is the most frequently used MeSH and keyword. Conclusions The change seen in literature in the last two decades, from hand washing and hand disinfection to hand hygiene, most probably reflect the paradigm shift favouring use of ABHR over soap and water promoted by international guidelines in the early 2000s.

The aim of was to analyzing the infection control practices in the Orthopedic department of a tertiary care hospital of South India. Methods: A total of 535 events were observed using structured observation checklist through participatory observation in this descriptive cross sectional study. The events were observed by the researchers during the patient care activities. Ethical clearance and consent was obtained. Results: Hand disinfection before the procedure was 54.4% and 75.5% after the procedure. Performing hand washing techniques was better with soap and water than using a sanitizer. Use of personal protective equipment, personal factors and removal of jewellery were good (above 80.8%). The compliance towards infection control practices during the various procedures ranged from 74.6% to 97.7%. Conclusion: Compliance towards infection control practices was good except for hand disinfection. The hand wash is key element in infection control. Therefore, behavioral change intervention may be useful in improving the compliance to hand washing.

Introduction: Hands are the most important way of transmitting infection. So, disinfecting hands with an appropriate substance is the most important prevention method. Therefore, the present study aimed to compare the effect of thyme spray and that of Decosept on the microbial load of nurses’ hands. Methods: 70 nurses working in different wards of Valiasr Hospital in the city of Arak, Iran, were selected according to inclusion criteria to participate in this clinical trial. After acquiring written consents, an initial culture was obtained from each participant on Blood Agar media. The participants were assigned to two groups. The first group disinfected their hands with thyme spray at 10% concentration and the second group disinfected their hands with Decosept. After drying the hands, a second culture sample was taken from each participant. Then, differential culture technique was performed and the results were analyzed by SPSS 16 and through t-test, Mann–Whitney, Fisher and Chi-squared tests. Results: The results showed that both substances used in the intervention caused a reduction in microbial load of the participants’ hands (p=0.0001), but this reduction was significantly higher after using Decosept compared to thymus (p= 0.0001). Conclusion: The results of this study showed that the antimicrobial effect of Decosept is higher than that of thymus. However, due to increasing attempts to use plant-based antibacterial agents, considering the findings of this study to this aim is recommended.