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Hand Hygiene and Mask-Wearing Practices during COVID-19 among Healthcare Workers: Misinformation as a Predictor.

ABSTRACT: Poor public health information is a hurdle in infectious disease control. The study aims to examine whether healthcare workers adhere to hand hygiene and mask-wearing guidelines during the COVID-19 pandemic and to explore their exposure to misinformation about the pandemic as a predictor. A cross-sectional survey was sent to 518 healthcare workers across Indonesia, the fourth largest nation in the world, in September 2020 during the COVID-19 pandemic. The respondents reported whether they adhered to the guidelines of hand hygiene and mask wearing and whether they believed in four pieces of misinformation about the origin, severity, contagion, and prevention of COVID-19. The association between misinformation and hand hygiene and mask wearing was tested with logistic regression models controlling for demographic and health-related covariates. Approximately 25% of healthcare workers did not always adhere to hand hygiene guidelines and approximately 5% did not adhere to mask-wearing guidelines. There are significant associations between all four pieces of misinformation and hand hygiene and mask wearing. It is important to improve public health information about COVID-19, which may hold key to healthcare workers' hand hygiene and mask wearing and to protect their health and patients' safety.

SUBMITTER: Wang S

PROVIDER: S-EPMC8641349 | biostudies-literature |

REPOSITORIES: biostudies-literature

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COVID-19 outbreak and healthcare worker behavioural change toward hand hygiene practices.

Project description:BackgroundThe coronavirus disease (COVID-19) pandemic has affected healthcare workers (HCWs) in their clinical practice. HCWs were challenged with new guidelines and practices to protect themselves from occupational risks.AimTo determine whether hand hygiene behaviour by real-time measurement was related to the dynamic of the epidemic, and the type of patient being cared for in France.MethodsThis study used an automated hand hygiene recording system to measure HCW hand hygiene on entry to and exit from patient rooms throughout the COVID-19 pandemic. The correlation between hand hygiene compliance and COVID-19 epidemiological data was analysed. Analysis of variance was performed to compare compliance rate during the different periods of the epidemic.FindingsHCW hand hygiene rate on room entry decreased over time; on room exit, it increased by 13.73% during the first wave of COVID-19, decreased by 9.87% during the post-lockdown period, then rebounded by 2.82% during the second wave of the epidemic. Hand hygiene during patient care and hand hygiene on room exit had a positive relationship with the local COVID-19 epidemic; conversely, hand hygiene on room entry did not depend on the trend of the epidemic, nor on nursing of COVID-19 patients, and it decreased over time.ConclusionHCWs modified their behaviours to face the risk propensity of the pandemic. However, to improve the poor compliance at room entry, reducing confusion between the hand hygiene recommendation and glove recommendation may be necessary; disinfection of gloving hands might solve this issue.

| S-EPMC7948529 | biostudies-literature

Potential utilities of mask-wearing and instant hand hygiene for fighting SARS-CoV-2.

Project description:The surge of patients in the pandemic of COVID-19 caused by the novel coronavirus SARS-CoV-2 may overwhelm the medical systems of many countries. Mask-wearing and handwashing can slow the spread of the virus, but currently, masks are in shortage in many countries, and timely handwashing is often impossible. In this study, the efficacy of three types of masks and instant hand wiping was evaluated using the avian influenza virus to mock the coronavirus. Virus quantification was performed using real-time reverse transcription-polymerase chain reaction. Previous studies on mask-wearing were reviewed. The results showed that instant hand wiping using a wet towel soaked in water containing 1.00% soap powder, 0.05% active chlorine, or 0.25% active chlorine from sodium hypochlorite removed 98.36%, 96.62%, and 99.98% of the virus from hands, respectively. N95 masks, medical masks, and homemade masks made of four-layer kitchen paper and one-layer cloth could block 99.98%, 97.14%, and 95.15% of the virus in aerosols. Medical mask-wearing which was supported by many studies was opposed by other studies possibly due to erroneous judgment. With these data, we propose the approach of mask-wearing plus instant hand hygiene (MIH) to slow the exponential spread of the virus. This MIH approach has been supported by the experiences of seven countries in fighting against COVID-19. Collectively, a simple approach to slow the exponential spread of SARS-CoV-2 was proposed with the support of experiments, literature review, and control experiences.

| S-EPMC7228401 | biostudies-literature

Wearing a mask-For yourself or for others? Behavioral correlates of mask wearing among COVID-19 frontline workers.

Project description:Human behavior can have effects on oneself and externalities on others. Mask wearing is such a behavior in the current pandemic. What motivates people to wear face masks in public when mask wearing is voluntary or not enforced? Which benefits should the policy makers rather emphasize in information campaigns-the reduced chances of getting the SARS-CoV-2 virus (benefits for oneself) or the reduced chances of transmitting the virus (benefits for others in the society)? In this paper, we link measured risk preferences and other-regarding preferences to mask wearing habits among 840 surveyed employees of two large Swiss hospitals. We find that the leading mask-wearing motivations change with age: While for older people, mask wearing habits are best explained by their self-regarding risk preferences, younger people are also motivated by other-regarding concerns. Our results are robust to different specifications including linear probability models, probit models and Lasso covariate selection models. Our findings thus allow drawing policy implications for effectively communicating public-health recommendations to frontline workers during the COVID-19 pandemic.

| S-EPMC8289104 | biostudies-literature

Qualitative assessment of hand hygiene knowledge, attitudes and practices among healthcare workers prior to the implementation of the WHO Hand Hygiene Improvement Strategy at Faranah Regional Hospital, Guinea

Project description:Healthcare-associated infections are a serious burden globally. Few qualitative studies have explored healthcare workers’ knowledge, attitudes and practices of hand hygiene. Prior to the implementation of the World Health Organization’s Hand Hygiene Improvement Strategy at Faranah Regional Hospital in the Upper Region of Guinea in December 2018, we conducted a qualitative baseline assessment of knowledge, attitudes and practices of hand hygiene among healthcare workers to guide future hand hygiene interventions. The qualitative study consisted of direct observations, In-Depth Interviews (IDIs) and Focus Group Discussions (FGDs). We found that the 2013–16 Ebola outbreak had had a pivotal impact on healthcare workers’ knowledge, attitudes and practices. The severity of the disease and the training provided for infection control were responsible for their knowledge acquisition and adoption of good attitudes and practices. However, negligence, resulting in poor hand hygiene practices, rose after the outbreak, once the “cue of fear” that had motivated workers for their own self-protection had waned. Our results suggest that local capacity building through training and availability of hand hygiene materials would be a sustainable approach to enhance hand hygiene culture at the hospital. Our study suggests that there is a need for a high and long-term commitment of authorities and healthcare workers at all levels for a sustainable hand hygiene culture.

| S-EPMC10021640 | biostudies-literature

Hand Microbiome Dynamics of Healthcare Workers

Project description:Impact of Technical Sources of Variation on the Hand Microbiome Dynamics of Healthcare Workers

| PRJEB5147 | ENA

Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India.

Project description:AimTo describe self-reported practices and assess knowledge and attitudes regarding hand hygiene among healthcare workers in a rural Indian teaching hospital.SettingA rural teaching hospital and its associated medical and nursing colleges in the district of Ujjain, India.MethodThe study population consisted of physicians, nurses, teaching staff, clinical instructors and nursing students. Self-administered questionnaires based on the World Health Organization Guidelines on Hand Hygiene in Healthcare were used.ResultsOut of 489 healthcare workers, 259 participated in the study (response rate = 53%). The proportion of healthcare workers that reported to 'always' practice hand hygiene in the selected situations varied from 40-96% amongst categories. Reported barriers to maintaining good hand hygiene were mainly related to high workload, scarcity of resources, lack of scientific information and the perception that priority is not given to hand hygiene, either on an individual or institutional level. Previous training on the topic had a statistically significant association with self-reported practice (p = 0.001). Ninety three per cent of the respondents were willing to attend training on hand hygiene in the near future.ConclusionSelf-reported knowledge and adherence varied between situations, but hand hygiene practices have the potential to improve if the identified constraints could be reduced. Future training should focus on enhancing healthcare workers' knowledge and understanding regarding the importance of persistent practice in all situations.

| S-EPMC5053486 | biostudies-literature

Hand Hygiene Social Norms Among Healthcare Workers During Early COVID-19: Results of a Global Survey.

Project description:Objectives: Poor hand hygiene among healthcare workers is an important driver of infectious disease transmission. Although social norms are considered a key determinant of hand hygiene behaviour, little is known about them among healthcare workers. This study describes hand hygiene social norms among health workers, assesses their predictors, and tests if social expectations increased during the early stages of COVID-19. Methods: We conducted a cross-sectional survey of healthcare workers from 77 countries (n = 1,233) from April to August 2020 assessing healthcare workers' hand hygiene social expectations, personal normative beliefs, punishment and reward, and demographic factors. Linear regressions and hierarchical linear modelling were used to analyse the responses. Results: We find high social expectations, personal beliefs, punishment, and rewards. Doctors tend to have lower social expectations than other occupation groups (e.g., nurses/midwives) and older respondents have higher social expectations. Social expectations increased during our survey, which may have been driven by COVID-19. Conclusion: Our findings suggest that hand hygiene social norms are strong among healthcare workers with variation across occupation and age; their strength increased during the COVID-19 pandemic. These have implications for behaviour change in healthcare environments that could leverage more norm-targeting interventions.

| S-EPMC9729248 | biostudies-literature

Does wearing a surgical mask influence face touching by healthcare workers? A retrospective cohort study.

Project description:ObjectiveAt the start of the COVID-19 pandemic, healthcare workers (HCW) in our ED were advised against and actively discouraged from wearing masks when not seeing respiratory patients, as mask wearing was thought to increase the risk of droplet transmission by face touching. The primary objective of the present study was to determine whether HCW using face masks were more or less likely to touch their faces than those not wearing masks.MethodsWe analysed six randomly selected hours of closed circuit television footage from our staff base. Face touches were recorded electronically by trained researchers. Generalised linear mixed models were used to compare the frequency and duration of face touches with and without face masks, controlling for individual clusters, adjusting for time of footage, duration on screen and staff role.ResultsData were collected from 187 HCW. Masks were worn in 231 (36%) of 642 screen sessions. Wearing a mask did not significantly change the odds of face touching (odds ratio 0.55, 95% confidence interval [CI] 0.30-1.01, P = 0.055) or duration of face touch (mean difference -1.45 s, 95% CI -8.84, 5.99, P = 0.71). For mucosal areas, a significant reduction in the odds of face touching was observed for mask wearers (odds ratio 0.21, 95% CI 0.11-0.43, P < 0.001) and on the frequency of mucosal touches (rate ratio 0.45, 95% CI 0.29-0.69, P < 0.001).ConclusionsMask wearing did not change face touching or the duration of face touches. However, significantly fewer mucosal touches were observed when wearing a mask, which may help to reduce nosocomial droplet transmission of viruses.

| S-EPMC10087437 | biostudies-literature

Comparison of two electronic hand hygiene monitoring systems in promoting hand hygiene of healthcare workers in the intensive care unit.

Project description:BackgroundHand hygiene (HH) is the cornerstone of infection control, and the promotion of HH is the focus of the world. The study aims to compare the role of two different types of electronic hand hygiene monitoring systems (EHHMSs) in promoting HH of healthcare workers (HCWs) in the intensive care unit (ICU).MethodsIn a 16-bed ICU of a general tertiary hospital in Shenzhen, the research was divided into three stages with interrupted time series (ITS) design. In the first stage, the direct observation method was used to monitor and feed back the HH compliance rate of HCWs monthly. In the second stage, the type1 EHHMS was applied to monitor and feed back the individual number of HH events monthly. In the third stage, the type2 EHHMS with a function of instant reminder and feedback was employed, and the personal HH compliance rates were fed back monthly. Meanwhile, direct observation continued in the last two stages.ResultsIn the second stage, The HH compliance rate increased. However, there was no significant difference in the trajectory of the rate compared with the first stage. In the first month of the third stage, the HH compliance rate increased by 12.324% immediately and then ascended by 1.242% over time. The number of HH events per bed day and HH products' consumption per bed day were consistent with the change of HH compliance rate observed.ConclusionMonitoring and feedback can improve the HH of HCWs. The EHHMS, with the function of real-time reminders and feedback, has a more noticeable effect on promoting HH.

| S-EPMC7802277 | biostudies-literature

Appropriate number of observations for determining hand hygiene compliance among healthcare workers.

Project description:We sought to determine the minimum number of observations needed to determine hand hygiene (HH) compliance among healthcare workers. The study was conducted at a referral hospital in South Korea. We retrospectively analyzed the result of HH monitoring from January to December 2018. HH compliance was calculated by dividing the number of observed HH actions by the total number of opportunities. Optimal HH compliance rates were calculated based on adherence to the six-step technique recommended by the World Health Organization. The minimum number of required observations (n) was calculated by the following equation using overall mean value (ρ), absolute precision (d), and confidence interval (CI) (1 - α) [the equation: [Formula: see text]]. We considered ds of 5%, 10%, 20%, and 30%, with CIs of 99%, 95%, and 90%. During the study period, 8791 HH opportunities among 1168 healthcare workers were monitored. Mean HH compliance and optimal HH compliance rates were 80.3% and 59.7%, respectively. The minimum number of observations required to determine HH compliance rates ranged from 2 ([Formula: see text]: 30%, CI: 90%) to 624 ([Formula: see text]: 5%, CI: 99%), and that for optimal HH compliance ranged from 5 ([Formula: see text]: 30%, CI: 90%) to 642 ([Formula: see text]: 5%, CI: 99%). Therefore, we found that our hospital required at least five observations to determine optimal HH compliance.

| S-EPMC8638267 | biostudies-literature

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