Degree of compliance with hand hygiene recommendations by health care personnel in an emergency department before and after the COVID-19 pandemic
e202111163
Keywords:
Hand Hygiene, Compliance, COVID-19, Emergency Department, Infection ControlAbstract
Background: Hand Hygiene (HH) is the most important measure to prevent healthcare-associated infections. The aim of this study was to determine the impact of the COVID-19 pandemic on the degree of compliance (DC) of HH in an Emergency Department (ED).
Methods: Cross-sectional study. DC of HH in the ED was calculated from 2005 to 2021. We studied the association between DC of HH and different variables (age, sex, status, ED area, time of WHO, etc.) by calculating the Odds Ratio (OR) and its 95% confidence interval (95%CI). To study the impact of the pandemic, we compared the C of HH before and after the onset of the COVID-19 pandemic, calculated the OR and its 95%CI.
Results: DC of HH increased to 75.9% (95%CI: 68.6%-83.2%) in the period after pandemic onset from the previous baseline period of 48.9% (95%CI: 43.4%-54.5%) (p<0.001). Factors significantly and independently associated with DC of HH were time period (before or after pandemic), attending training sessions, having alcohol solution in pocket format and WHO moments 3,4 and 5.
Conclusions: DC of HH in the ED has reached the highest value in 17 years of monitoring following the COVID-19 pandemic. This increase reflects a very positive change in the behavior of healthcare personnel with respect to HH.
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World Health Organization: Regional Office for Europe. Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level. Ginebra, Suiza: World Health Organization; 2016. (Consultado 4 mayo 2021). Disponible en: https://apps.who.int/iris/bitstream/handle/10665/251730/9789241549929-eng.pdf;jsessionid=6496491DA1E50BAD15A6B959F4C1584E?sequence=1
World Health Organization (WHO). WHO guidelines on hand hygiene in health care: First global patient safety challenge. Clean care is safer care. Ginebra, Suiza: World Health Organization; 2009. (Consultado 4 mayo 2021). Disponible en: https://apps.who.int/iris/bitstream/handle/10665/44102/
_eng.pdf?sequence=1
Pittet D. Compliance with hand disinfection and its impact on hospital-acquired infections. J Hosp Infect. 2001;48:S40–6.
Luangasanatip N, Hongsuwan M, Limmathurotsakul D, Lubell Y, Lee AS, Harbarth S et al. Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis. BMJ. 2015;351:h3728.
Stewardson AJ, Stuart RL, Marshall C, Cruickshank M, Grayson ML. More doctor–patient contact is not the only explanation for lower hand-hygiene compliance in Australian emergency departments. Infect Control Hosp Epidemiol. 2017;38:502–504.
Muller MP, Carter E, Siddiqui N, Larson E. Hand hygiene compliance in an emergency department: The effect of crowding. Acad Emerg Med. 2015;22:1218–1221.
World Health Organization. WHO Director-general’s opening remarks at the media briefing on COVID-19. 2020. (Consultado 7 marzo 2021). Disponible en: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
World Health Organization. Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected. Interim guidance. 2020. (Consultado 7 marzo 2021). Disponible en: https://apps.who.int/iris/handle/10665/330674
European Centre for Disease Prevention and Control. Infection prevention and control and preparedness for COVID-19 in healthcare settings – Sixth update. 9 February 2021. ECDC: Stockholm; 2021. (Consultado 7 marzo 2021). Disponible en: https://www.ecdc.europa.eu/sites/default/files/documents/Infection-prevention-and-control-in-healthcare-settings-COVID-19_6th_update_9_Feb_2021.pdf
Derksen C, Keller FM, Lippke S. Obstetric healthcare workers’ adherence to hand hygiene recommendations during the COVID-19 pandemic: Observations and social-cognitive determinants. Appl Psychol Health Well Being. 2020;12:1286–1305.
Prescott K, Mahida N, Wilkinson M, Gray J. Hand hygiene: a COVID beneficiary? J Hosp Infect. 2021;111:4-5.
Carter EJ, Pouch SM, Larson EL. Common infection control practices in the emergency department: a literature review. Am J Infect Control. 2014;42:957–962.
Seo H-J, Sohng K-Y, Chang SO, Chaung SK, Won JS, Choi M-J. Interventions to improve hand hygiene compliance in emergency departments: a systematic review. J Hosp Infect. 2019;102:394–406.
Sánchez-Payá J, Hernández-Garcia I, Camargo R, Villanueva CO, Martín AC, Roman F et al. Higiene de manos en urgencias: grado de cumplimiento, determinantes y su evolución en el tiempo. Emergencias. 2012;24:107-112.
Chico-Sánchez P, Gras-Valentí P, Mora-Muriel JG, Algado-Sellés N, Sánchez-Payá J, Llorens P; Grupo de Trabajo COVID-19 del Servicio de Medicina Preventiva; Grupo de Trabajo COVID-19 de la Comisión de Infecciones. Impact of the COVID-19 pandemic on health care workers in a tertiary care hospital emergency department. Emergencias. 2020;32:227-232.
Ministerio de la Presidencia, Relaciones con las Cortes y Memoria Democrática. Real Decreto 463/2020. Declaración del Estado de Alarma. España. (Consultado 24 mayo 2021). Disponible en: https://www.boe.es/eli/es/rd/2020/03/14/463
Ragusa R, Marranzano M, Lombardo A, Quattrocchi R, Bellia MA, Lupo L. Has the COVID 19 virus changed adherence to hand washing among healthcare workers?. Behav Sci. 2021;11:53.
Erasmus V, Daha TJ, Brug H, Richardus JH, Behrendt MD, Vos MC et al. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol. 2010;31:283–294.
Vikke HS, Vittinghus S, Giebner M, Kolmos HJ, Smith K, Castrén M et al. Compliance with hand hygiene in emergency medical services: an international observational study. Emerg Med J. 2019;36:171–175.
Arntz PRH, Hopman J, Nillesen M, Yalcin E, Bleeker-Rovers CP, Voss A et al. Effectiveness of a multimodal hand hygiene improvement strategy in the emergency department. Am J Infect Control. 2016;44:1203–1207.
Di Martino P, Ban KM, Bartoloni A, Fowler KE, Saint S, Mannelli F. Assessing the sustainability of hand hygiene adherence prior to patient contact in the emergency department: A 1-year postintervention evaluation. Am J Infect Control. 2011;39:14–18.
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Copyright (c) 2021 Paula Gras-Valentí , María Guerrero-Soler, Pablo Chico-Sánchez, Ángela Sanjuan-Quiles, José Sánchez-Payá, Pere Llorens, Grupo de Trabajo de COVID-19 del Servicio de Medicina Preventiva
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