Abstract
The aim of the study was to assess adherence to hand washing by healthcare workers (HCWs) and its variations over time in hospital wards. We wanted to check whether the pandemic had changed the behavior of HCWs. The study was conducted between 1 January 2015, and 31 December 2020. The HCWs were observed to assess their compliance with the Five Moments for Hand Hygiene. We described the percentage of adherence to World Health Organization (WHO) guidelines stratified per year, per specialty areas, per different types of HCWs. We also observed the use of gloves. Descriptive data were reported as frequencies and percentages. We observed 13,494 hand hygiene opportunities. The majority of observations concerned nurses who were confirmed as the category most frequently involved with patients. Hospital’s global adherence to WHO guidelines did not change in the last six years. During the pandemic, the rate of adherence to the procedure increased significantly only in Intensive Care Unit (ICU). In 2020, the use of gloves increased in pre-patient contact. The hand-washing permanent monitoring confirmed that it is very difficult to obtain the respect of correct hand hygiene in all opportunities, despite the ongoing pandemic and the fear of contagion.
Highlights
Hands are the main vehicle of infection in healthcare
It was reported that the growing awareness of healthcare workers (HCWs) on the importance of hand washing causes a reduction of about 30% in the transmission of infectious agents [11]
The HCWs were observed during working shifts to assess their compliance with “Five Moments for Hand Hygiene” extracted from the World Health Organization (WHO) Guidelines on Hand Hygiene in Healthcare [4]—before touching a patient or before having contact with an object belonging to the healthcare area; before a clean/aseptic procedure; after body fluid exposure; after touching a patient, and after touching patient surroundings
Summary
Hands are the main vehicle of infection in healthcare. The increasingly frequent use of digital devices multiplied the opportunities for contact between hands and the environment. The repeated pressures of the fingertips, sometimes covered with gloves and sometimes not, on cell phone or on workstation keyboards, PCs, monitors, or buttons of electromedical equipment makes these objects become vehicles of infections [1,2] Recent evidence showed the possibility of coronavirus transmission after contact with a contaminated dry surface [3]. Even though the World Health Organization (WHO) and Centers for Disease control the guidelines and recommendations for appropriate hand hygiene (HH) practices since 2002 [4,5], the compliance with this practice remains poor, in the majority of cases [6]. It was reported that the growing awareness of HCWs on the importance of hand washing causes a reduction of about 30% in the transmission of infectious agents [11]
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