Analysis of Compliance and Barriers for Hand Hygiene Practices among Health Care Workers during COVID-19 Pandemic Management in Tertiary Care Hospital of India—An Important Step for Second Wave Preparedness

Abstract

Introduction: Hands of health care workers play an important part in infection transmission in a healthcare setting infections. Even though it is a simple and effective procedure, it is many times ignored by the health care workers (HCWs) due to lack of knowledge and interest, time constraints, skin irritation, understaffing, etc. There are no specific drugs and vaccines available for COVID-19 pandemic management, so as control measures, hand hygiene is an essential measure. It will be helpful even for the second wave preparedness. So this study was planned for analysis of barriers and practices of hand hygiene among health care workers which determine the adherence of hand hygiene in medical practice. Methods: This was a cross-sectional study designed during COVID-19 pandemic management to analyze the barriers and knowledge, attitude and practices in health care workers for hand hygiene. Semi-structured questionnaires based study based on previous experience of seasonal flu outbreak was make to know barriers as well as to analyze the knowledge, attitude and practices of Health care workers. 215 participants were enrolled who were doctors, resident doctors, nurses, lab technicians, ward boys and food distributors. Results: The “Barriers” related questions’ analysis showed that hand hygiene facilities, with the supply of soap, hand rub, basins with adequate as well as clean water, are available at various places in the Hospital. In knowledge related questions, major gaps are found in 5 moments of hand hygiene and regarding aspects of alcohol-based hand-rub. Majority HCWs show a good attitude towards questions that hand hygiene is an important thing to do along with other works and they feel frustrated when others or they themselves omit hand hygiene. But the attitude toward hand hygiene when hands are not visibly soiled and when working with gloved hand showed a wrong attitude. There is a major gap in practices of hand hygiene. The majority feel hand hygiene is difficult due to work pressure, sometimes they forgot, they feel it difficult to adhere due to more steps during an emergency. Discussion: Hand hygiene is an essential part of COVID-19 pandemic management. Less compliance was observed due to a lack of knowledge and awareness. Such ignorance leads to an increase in Hospital-acquired infection. Conclusion: Good preparedness by Government and Institute for supplying adequate hand hygiene facilities in the work area for health care workers. But there were few gaps found in knowledge and attitude-related questionnaires and major gaps in practices were found which should be corrected by repeated training, awareness programs, demonstrations for hand hygiene and hands-on training. Conducting Periodic Webinar can be the most useful, convenient and safe method to provide training during the COVID-19 pandemic.