An Intra-COVID-19 Assessment of Hand Hygiene Facility, Policy and Staff Compliance in Two Hospitals in Sierra Leone: Is There a Difference between Regional and Capital City Hospitals?

Sulaiman Lakoh,Christine Ellen Elleanor Williams,Emmanuel Firima,Gibrilla F Deen,Joseph Sam Kanu,Darlinda F Jiba,Christiana Kallon,Le Yi,Xuejun Guo,Mohamed Gbeshay Sheku,Anna Maruta,Olukemi Adekanmbi,Chukwuemeka Haffner,Enanga Sonia Namanaga,Mohamed Samai,Umu Barrie,Stephen Sevalie,Mohamed Boie Jalloh,Gladys Nanilla Kamara,Matilda N Kamara,Sarah K Conteh ,Joseph Okeibunor ,Mohamed Kamara ,Ssemudu Julius Kamara ,James Russell

doi:10.3390/tropicalmed6040204

Abstract

Although hand hygiene (HH) is the most effective intervention to reduce the spread of infections, there are limited data on HH facilities, policy, and compliance in sub-Saharan Africa. This cross-sectional study is aimed at assessing HH using the WHO HH self-assessment framework, HH technical reference manual, and a modified infection control self-assessment tool in two hospitals in Sierra Leone. Only 10% and 9% of regional and capital city hospitals had running tap water, respectively. Veronica buckets were the resources for HH in 89% of units in the regional hospital and 92% of units in capital city hospital. Constant supply of soap and alcohol-based hand rub was available in 82% and 68%; and 74% and 79% of units in the capital city and regional hospitals, respectively. Only 10% of the units in both hospitals had hand-drying facilities and functional sinks. Overall HH compliance for the two hospitals was 18.6% and was higher in the regional (20.8%) than the capital city (17.0%) hospitals. The HH levels for the capital city and regional hospitals were 277.5 and 262.5 respectively. Despite the COVID-19 pandemic, there are still challenges with HH compliance in Sierra Leone. It is, therefore, necessary to strengthen the HH multi-modal strategy.

Highlights

Healthcare-associated infections (HAI) are a major global health problem, causing millions of healthcare-related morbidity and mortality every year [1]
All units/wards/departments ofof thethe two hospitals hadhad at least oneone hand-washing staAll units/wards/departments two hospitals at least hand-washing tion, butbut only of the units/wards/departments in theinregional and capital cities station, only of the units/wards/departments the regional and capital hospitals had running tap water
Veronica bucketsbuckets were the resources for handfor hygiene cities hospitals had running tap water

Summary

Introduction

Healthcare-associated infections (HAI) are a major global health problem, causing millions of healthcare-related morbidity and mortality every year [1]. Proper hand hygiene practices, including washing hands with soap and water or using alcohol-based hand rubs, are the most effective interventions to reduce the spread of infections in healthcare settings [5,7]. Both are simple and quick techniques to prevent HAI, and if implemented correctly, they can save lives, reduce morbidity, and minimize healthcare costs [2]. WHO defines the key moments when medical staff should perform hand hygiene: before patient contact, before an aseptic procedure, after bodily fluid exposure risk, after patient contact, and after contact with patient surroundings [8]

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