The COVID-19 pandemic prompted health authorities to adopt measures to protect the population by curbing the spread of the virus. Given that SARS-CoV-2 is primarily transmitted through close contact with infected droplets, aerosols, or contaminated surfaces, the measures implemented include social distancing, adherence to hand hygiene rules, and vaccination of the population. To assess compliance with anti-COVID-19 barrier measures implemented by dispensing pharmacists after the pandemic, we conducted a descriptive cross-sectional study. The study included 117 dispensing pharmacists, 74% of whom practiced in urban areas. The results of our research show that anti-COVID-19 barrier measures in pharmacies are partially maintained at 74%. The use of glass barriers over countertops is at the top of the list, at 71%, followed by hand disinfection with hydroalcoholic gel after each user visit, at 27%. Other measures, such as the wearing of masks, the presence of a hydroalcoholic gel dispenser at the entrance, limiting the number of users in the pharmacy, as well as the indication of one-way traffic and physical distance lines on the floor, are applied at rates of 1%, 6%, 3% and 4% respectively. Our study also revealed that 45% of dispensing pharmacists support maintaining or extending anti-COVID-19 barrier measures in their pharmacies. It is essential to note that although working in a pharmacy requires close interaction with users, maintaining distancing and hand hygiene measures remains crucial for reducing the risk of infectious disease transmission, thereby promoting a safe and healthy environment for both pharmacy staff and users.

Background: Hand hygiene (HH) using alcohol-based hand rub is critical for preventing surgical site infections. Despite multiple HH opportunities during perioperative care, compliance among operation room staff remains unclear. Objectives: This study aimed to observe HH compliance among surgical and anesthesia and nursing staff in operating theatres at a governmental hospital in Jordan offering general and speciality surgeries. Methods: A trained observers assessed HH compliance based on the WHO’s “My 5 Moments for Hand Hygiene” (WHO-5) model. A total of 930 HH opportunities were recorded. Chi-square test and cross-tabulations were used to comparing occupational groups and medical specialties. Results: Of the 930 observed opportunities, 46.2% were compliant. HH compliance was highest after body fluid exposure (55.9%) and lowest after contact with patient surroundings (33.0%). Most observations (72.8%) occurred inside the operating room. Significant differences in compliance were observed between males and females. Conclusion: Although healthcare professionals understand the importance of HH, high workload and overlapping procedures hinder compliance. Hospital management should implement targeted interventions and stricter monitoring to improve HH adherence in surgical settings. Nursing implication: Nurses should prioritize hand hygiene compliance by integrating it into workflow routines despite high workloads, thereby reducing surgical site infections and enhancing patient safety.

ObjectivesTo inform about behavioural gender and age differences in compliance with hand hygiene recommendations during the COVID-19 pandemic in Switzerland.DesignObservational study (24–25 June and 1–3 July 2020); validation study (4 December 2020); gender and age group estimated by observers.SettingObservations occurred in five supermarkets.ParticipantsAll customers entering the supermarkets during a 3-hour period per day (n=8245 main study) and during 1 day (n=1918 validation study).Main outcome measuresWe observed whether people disinfected their hands.ResultsThe study reveals considerable differences with respect to gender and age: For women, 58.7% (95% CI 57.3 to 60.0%) were disinfecting their hands vs 50.4% (95% CI 48.6 to 52.2%) of men. With respect to age, we identified a steep increase across age groups up to the age of 60 years and older with 35.5% (95% CI 30.7 to 40.5%) of youth (12-17 yrs) disinfecting their hands, 50.5% (95% CI 49.1 to 51.9%) of adults (18-59 yrs) vs 69.0% (95% CI 67.1 to 70.9%) of the golden age group (60-74 yrs) and 67.2% (95% CI 61.1 to 72.9%) of people older than 75 years. The validation study confirmed these differences.ConclusionsThe study documents substantial differences in hand hygiene compliance between gender and age groups. This should be considered in the design of protective measures to ensure clean and safe hands.

Background: Appropriate hand hygiene is one of the most important ways to reduce the transmission of pathogens and prevent healthcare-associated infections (HCAIs), but the rate of compliance among doctors remains low. The purpose of this study is to evaluate the impact of the COVID-19 pandemic on the rate of hand hygiene compliance among doctors during outpatient consultations. Method: This study was conducted on doctors providing outpatient care at Mie University Hospital (Japan) from January 2019 to December 2023. The electronic counting device, Hand Hygiene Monitoring System Compleo-IO, was used, which automatically tallies the amount of alcohol-based hand sanitizer used by installing a wireless device under the hand sanitizer dispenser. The hand hygiene compliance rate was calculated by dividing the number of times hand disinfection was performed by the number of patients receiving outpatient care. We measured the hand hygiene compliance rate of each department and each doctor every month, and evaluated the changes in the impact of the pandemic on the hand hygiene compliance rate. In addition, we categorized the compliance rate into poor (0% to < 25%), average (25% to < 50%), and good (50% or more) categories, and visually evaluated the transition of the categories over the years. Result: The hand hygiene compliance rate in 27 departments was 24.8% on average before the pandemic (2019), but rose to 35.2-39.4% in the early stages of the pandemic (2021-2022). However, in the late stages of the pandemic (2022-2023), it had returned to baseline values of 25.4-27.2%(figure1, 2). The hand hygiene compliance rate among individual doctors (based on 97 doctors for whom data could be measured continuously over a five-year period) was similarly 26.9% on average before the pandemic, but rose to 32.1% - 37.7% in the early stages of the pandemic. However, in the late stages of the pandemic, it had returned to baseline values of 26.0-26.6%(figure 3,4). Conclusion: During the unprecedented COVID-19 pandemic, hand hygiene compliance rates increased in the early stages of the pandemic, but eventually returned to pre-pandemic levels. We hope to use this experience to help us improve compliance rates on an ongoing basis.

ABSTRACTObjectiveThe aim of the study was to determine the prevalence of antibodies against hepatitis E virus (HEV), tick‐borne encephalitis virus (TBEV), West Nile virus (WNV), Crimean–Congo haemorrhagic fever (CCHF) virus, rabies virus, Echinococcus spp., Brucella spp., as well as the colonisation with methicillin‐resistant Staphylococcus aureus (MRSA) among Austrian veterinarians in dependence on their field of occupation, age, gender and, if applicable, the vaccination status.Methods and resultsA total of 293 Austrian veterinary practitioners were included in the study. All study participants had to fill in a questionnaire regarding personal details, field of occupation and vaccination status against TBEV and rabies. Furthermore, a nasal swab for detection of colonisation with MRSA and a blood sample were taken. Antibodies against HEV, TBEV, WNV, CCHF virus and Echinococcus spp. were analysed by ELISA tests. Antibodies against Brucella spp. were measured by complement fixation test. Rabies antibodies were analysed by virus neutralisation test. Most study participants were vaccinated against rabies (93.2%) and TBEV (94.3%). Accordingly, a high prevalence of TBEV antibodies was found (95.9%). HEV antibodies were detected in 11.3% of the study participants, with a significantly higher seroprevalence in the oldest age group (23.3%). MRSA colonisation was age‐depended and significantly higher in study participants with occupational livestock exposure (10.3% vs. 2.2%). Hygienic measures such as hand washing and disinfection led to less MRSA colonisation. Antibodies against WNV were found in 3.1% of the study participants. No antibodies against Brucella spp., Echinococcus spp. and CCHF were detected.ConclusionsDespite the limitations of the study design, the included veterinarians represent the Austrian average veterinarians regarding gender, age and field of occupation. The vaccination rate against TBEV and rabies was high. HEV seroprevalence was lower than in other studies, whereas MRSA colonisation rates and WNV seroprevalence were comparable to results of other European studies.

This pilot study aims to assess changes in nurses’ knowledge of hand hygiene before and after the implementation of a blended learning method ‒ combining an eight-hour practical simulation with an e-learning module ‒ based on the World Health Organization’s (WHO) ‘My 5 Moments for Hand Hygiene’ framework, and to provide further scientific insight into the applicability of this educational approach. The study focuses on three key research questions: 1) how e-learning and practical simulations influence nurses’ awareness of hand hygiene principles based on the WHO ‘My 5 Moments for Hand Hygiene’ framework, 2) whether there are statistically significant differences in nurses’ knowledge before and after the blended learning intervention by the WHO framework, and 3) how suitable the assessment tool used in this study is for planning more extensive research in the future. The participants are the nurses who attended the training. Data were collected using the WHO hand hygiene knowl- edge questionnaire from March to May 2023, and responses from 50 (91%) participants were analysed. Although this is a small-scale study, the results show significant improvement in awareness regarding hand hygiene methods after exposure to blood (52% vs 80%, χ2 = 8.369, p = 0.004), the need for hand cream (74% vs 90%, χ2 = 6.342, p = 0.042), and the use of hand disinfection and washing techniques (78% vs 92%, χ2 = 3.843, p = 0.050). However, no improvement was seen in nurses’ understanding of hand hygiene after emptying a bedpan. Additionally, there was insufficient awareness that the contaminated hands of healthcare workers are a significant source of germs in healthcare settings. The study found no links between nurses’ knowledge and their gender, age, or department. The assessment tool used in this study is suitable for conducting a more extensive analysis.

ABSTRACT Objective This study aims to investigate the effects of bundle-based preventive care on the control of healthcare-associated infections (HAIs) in patients undergoing neurosurgical procedures. Methods One hundred and twenty patients who underwent neurosurgery were enrolled and randomly assigned, using a random number table method, to either the control group (n = 60), which received routine nursing care, or the observation group (n = 60), which bundle-based preventive care. The incidence of HAIs, antibiotic usage, and pathogen detection rates were compared between the two groups. In addition, adverse events and length of hospital stay were recorded. Nursing quality and patient satisfaction were also evaluated. Results The observation group showed significantly better outcomes than the control group. Specifically, its HAI rate (6.67% vs. 21.67%) and total pathogen detection rate (6.67% vs. 20.00%) were significantly lower (p < 0.05). The use of dual and triple antibiotic regimens was also reduced (p < 0.05). Moreover, the observation group experienced fewer adverse events and a shorter hospital stay (p < 0.05). Nursing quality scores – including hand hygiene, disinfection and isolation, nursing communication, and documentation – were all higher in the observation group (p < 0.05). Patient satisfaction was significantly improved as well (95.00% vs. 83.33%, p < 0.05). Conclusion Bundle-based preventive care can effectively reduce postoperative HAIs and antibiotic usage in neurosurgical patients, lower the incidence of adverse events, and significantly improve nursing quality and patient satisfaction.

In the event of adisaster, compliance with basic hygiene measures is crucial. These measures are carried out regardless of the colonization or infection status of the patient in order to prevent the transmission of pathogens to other patients and personnel and to minimize the risk of a nosocomial distribution of (potential) infectious pathogens. This primarily includes hygienic hand disinfection and the use of special barrier precautions and personal protective equipement depending on the situation as well as safe injection and infusion techniques, proper processing of medical products and full vaccination protection of the personnel. When consistently applied basic hygiene measures also protect against the transmission of multidrug-resistant pathogens in undetected colonized patients and many viral infections. Due to amassive increase in demand (e.g., during the pandemic), disruptions in supply chains or breakdowns in facility-specific structures, prolonged shortages of materials that are important for implementing basic hygiene can occur. In these situations, substitution strategies are required, e.g., for the in-house production of hand and surface disinfectants, the handling of drinking water, alternative ways of processing medical products, wound care and the use of antibiotics.

Due to the development of antibiotic resistance in many bacterial species, the demands in nursing care have changed significantly. In handling urine catheters in home care, ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) pathogens may present as urinary tract infections or in bacteriuria. However, increasing challenges in hygiene and infection prevention is faced by an increasing number of health assistants and aides with limited knowledge on pathogen systematics, bacterial reservoirs, and pathogen spread. The use of hygiene aids during preparation and emptying the urinary drainage bag for atetraplegic disabled person were observed and recorded. The advantages of using disinfection wipes by nursing personnel and aides during emptying of urine bags is encouraging. Rapid accessibility of well-placed wipes increases the frequency of reaching several times for awipe during acritical workflow, compared to the use of adispenser for hand disinfection. Potentially contaminating touches from the urine outlet or bucket into the area around the bed, or the use of the working hand to touch the glasses, hair, or clothes of the nurse are largely reduced. The touching of the bathroom faucet with apotentially contaminated glove is replaced by reaching for a disinfectant wipe. By preventing the use of acontaminated hand in an area that needs to remain hygienic by reaching for a disinfectant wipe potentially stops the spread of pathogens. The frequent and deliberative use of wipes significantly reduces the risk of pathogen spread in ahome nursing environment.

Is sterility essential for hand-drying products in surgical hand antisepsis? A controlled before-and-after study.

This study investigates the impact of hand representation in virtual reality based medical education on user behaviour, with a particular focus on medical teaching objectives and navigation within the scenario. In VR it is common to adapt established concepts from other disciplines. One way of representing the hands in VR is to follow common design concepts and stay within a colour scheme that includes all interaction elements. In a medical context, this can lead to the hands not being perceived as “naked” and raises the question of whether important hygienic routines for protecting oneself and others are not being performed. A randomised, double-centre trial was conducted with medical students from the University of Münster and the University of Saarland. Participants were assigned to one of two virtual hand representations - realistic or artificial (green). The study assessed students’ performance in a VR-based skin cancer screening simulation, focusing on their adherence to hygiene protocols and subjective experiences of presence and embodiment. No significant differences were found in perceived embodiment between the two hand variants. While realistic hands significantly improved the frequency of glove use, artificial hands had a small positive effect on initial navigation. No significant differences were found in door closing and hand disinfection behaviours. Participants subjectively preferred the realistic hands for future VR-based scenarios. The use of realistic hand representation seems to have an advantage for training hand-related routines in medicine, while the use of interaction-friendly design facilitates navigation for learners. Depending on the use case of new applications and intended learning outcomes, these findings should be taken into account when developing new applications. Close interdisciplinary collaboration in development is highly relevant in order to identify and address such distinctive requirements.

Observing is influencing: How hand disinfection compliance observations affect hand disinfection rates; specifics derived from an electronic monitoring system.

Multidrug-resistant organismspose a significant challenge in intensive care units (ICUs). Despite contact precautions (CP) being recommended as an infection prevention measure, little is known about the burden of CP on health care workers (HCWs). An online survey was conducted between May 2021 and August 2022 at baseline (BP) and intervention period (IP) of a multicenter trial discontinuing CP for patients colonized with third-generation cephalosporin resistant gram-negative bacteria in which 38 ICUs participated. 147 HCWs from 33 ICUs (BP), 154 HCWs from 38 ICUs (IP) responded to the survey. At BP, most burdensome were:donning personal protective equipment(PPE) in case of emergency (84.0%), need of additional time (73.5%), elevated time management requirements to complete all daily tasks (68.7%), transport to diagnostic areas (65.2%). A significant reduction during IP was shown for:transport to diagnostic areas (p=.010), elevated time management requirements to complete all daily tasks (p=.004), need of additional time (p=.020), donning and doffing PPE (p=.014), increased hand and surface disinfection (p=.035) and anxiety (p=.031). Removing CP may be associated with considerable relief in burden for HCWs. However, removing CP must be guided by defined evidence since infection prevention control must be ensured.

This paper presents the design and development of an automated antibacterial gel dispenser with IoT capabilities for hand disinfection and body temperature monitoring, intended for access control in private spaces. All collected data are stored in a dedicated database. The system was developed using Arduino IDE, XAMPP, Blynk, Autodesk Eagle, Autodesk Fusion 360, and OnShape, integrating sensors such as the MLX90614, FC-51, and AS608. A compact PCB was designed using Autodesk Eagle, while a simple, easy-to-assemble enclosure was modeled with OnShape. A local server was configured using XAMPP to store data in a MySQL database via a PHP script, and the ESP32 microcontroller ensured the overall functionality of the dispenser. The device allows switching between user registration mode, stored data visualization, and standard operation mode, all controlled via the Blynk platform. This system promotes hygiene habits and enables early disease detection. It is currently operational at the Technological Center of Aragón, in the Measurement and Instrumentation Laboratory of the FES Aragón [UNAM].

To describe and compare attitudes toward hand hygiene and the perceived effectiveness of prevention methods among nursing students and registered nurses at a university and its affiliated university hospital. A descriptive cross-sectional comparative survey. A total of 201 first- and final-semester nursing students and registered nurses completed the World Health Organisation's 'Perceptions Survey for Health-Care Workers'. The survey examined perceptions on hand hygiene, patient safety and the usefulness of improvement measures. Responses were analysed using descriptive statistics. Nursing students consistently rated the importance of hand hygiene and related interventions higher than registered nurses. Students particularly emphasised the availability of hand disinfectants, ongoing education and supportive leadership. Both groups acknowledged the role of management support, regular feedback and organisational policies in reinforcing optimal hand hygiene. Differences in attitudes between nursing students and registered nurses underscore the need for ongoing education, strong managerial involvement and supportive policies to sustain adherence. Strengthening these factors can help maintain positive perceptions formed during training and enhance patient safety in clinical practice. Educational curricula and workplace strategies that prioritise hand hygiene may help lower healthcare-associated infections. Management-led feedback, continuous training and accessible hand hygiene resources offer additional support for safe patient care. What problem did the study address? Low adherence to hand hygiene is a key driver of preventable infections. What were the main findings? Nursing students rated hand hygiene and improvement measures more highly than registered nurses, highlighting a need for strategies that sustain positive attitudes during the transition from education to clinical practice. Who will benefit? Nurse educators, clinical leaders and healthcare workers can use these findings to improve infection prevention across educational and practice settings. We adhered to STROBE guidelines for cross-sectional research. No patients or members of the public were involved in designing or conducting this study, which focused on perceptions of nursing students and registered nurses.

Background: The adult intensive care unit comprises a total of 18 beds. On October 18, 2023, a text notification alerted us to a patient whose wound culture tested positive for Enterococcus faecium (VRE). Following protocol, an Anus VRE screening was conducted on the adjacent bed, revealing three additional positive cases, suggesting a cluster outbreak. Investigation and management were initiated. Methods: Through interviews, observations, medical record reviews, and expanded VRE screenings, a total of 8 beds tested positive, resulting in a positivity rate of 44.4% (8/18), all cases being colonization. Root cause analysis identified failures in hand hygiene among healthcare workers (HCWs), failure to wash hands before donning gloves, incorrect sequencing of environmental cleaning and disinfection, and inadequate implementation of contact isolation precautions. Measures included conducting Anus VRE screening for ICU admissions from October 15th to 18th, increasing the frequency of unit cleaning and disinfection, providing education and training, auditing hand hygiene practices and isolation measures, and centralizing VRE patient care. Results: Utilization of multiple measures for controlling drug-resistant bacterial infections, including auditing hand hygiene, environmental cleaning and disinfection, implementing contact isolation precautions, and conducting environmental sampling, yielded negative results. Observation until November 30th showed no new cases, effectively controlling the spread of drug-resistant bacteria and preventing healthcare-associated infections due to VRE. Discussion: Despite HCWs’ often busy clinical care responsibilities leading to neglect of hand hygiene or substituting handwashing with glove usage, and lapses in implementing contact isolation precautions, no healthcare-associated infections occurred, and patients were successfully discharged without disease exacerbation or fatalities. Environmental sampling was conducted post-environmental disinfection. Additionally, all VRE-positive patients were identified as Enterococcus faecium (VRE). Due to limitations, PFGE testing couldn’t be conducted, hence strain and susceptibility determination confirmed the same VRE colonization event within the hospital.

International travellers have the potential to transmit multidrug-resistant bacteria. However, the role of hygiene measures during travel has yet to be investigated. Travellers were asked about their use of disinfectants and hygiene behaviour. Stool samples were analysed for Gram-negative multi-resistant bacteria (MDRO). These data were analysed, and a new MDRO risk map was developed and compared with data from existing literature. Of 214 travellers, 6 (2.8%) tested positive for an MDRO before and 16 (7.5%) after the trip, with travel in known high-risk MDRO areas. Most travellers, 174 (81.3%), regularly used disinfectants; only 36 (16.8%) did not. There was no statistically significant correlation between the use of a disinfectant and colonisation with MDRO. In our and comparable studies, a high-risk region on the risk map was associated with an increased number of MDRO or extended-spectrum beta-lactamase (ESBL) positive returns. Travellers showed a high willingness to use disinfectants. This preliminary study highlights the need for larger, randomized studies to better assess the true impact of hand disinfectants on MDRO acquisition.

Aim: This study was conducted to evaluate the attitudes of surgical nurses toward hand sanitizers in daily life. Material and Method: The sample of this descriptive study consisted of surgical nurses who lived in Turkey, volunteered for the research and met the inclusion criteria. The sample size calculation was made according to the sample calculation with an unknown population. According to this calculation, the number of samples was determined to be at least 385 at a 95% confidence interval and ± 5% sampling error. The online questionnaire created on Google Forms was delivered to 452 participants through social media applications. Information Form was developed by the researcher based on the relevant literature was used as a data collection tool. Results: Participants reported confusion when selecting disinfectants due to insufficient attention to product content. It was found that although participants are surgical nurses, they lack information on the effective alcohol content of alcohol-based hand sanitizers, the amount to be used, and the duration of hand rubbing. Conclusion: The significance of conducting studies to raise awareness among nurses on the correct use of hand disinfectants is emerging.

Background: Due to the COVID-19 pandemic announced in Poland in 2020, a number of recommendations were introduced, including hand disinfection and the use of personal protective equipment (PPE). The aim of this study was to present the impact of chronic use of PPE on the condition of the skin in the era of COVID-19. Materials and Methods: People aged 15–75, regardless of their health status and education level, living in Poland, were invited to participate in a survey using anonymous online questionnaires. Data analysis was performed in the R statistical environment, ver. 3.6.0, PSPP software, and Microsoft Office 2019. Results: Out of the 513 participants, 24.9% were health-care workers, 53.8% were medical students, and 21.3% were non-medical professionals, with the majority being women (82.3%). In each of these groups, when PPE was used, exacerbation of skin problems occurred more often (n = 300, 60.9%) than the appearance of new ones (n = 250, 49.9%). The group in which skin lesions most often intensified (n = 178, p = 0.013) and new ones appeared (n = 153, p = 0.02) were medical students. New dermatoses occurred more often in people who wore masks, face shields or goggles with a mask (face, n = 110, p = 0.001) as well as gloves and hand disinfection (hands, n = 114, p = 0.001) compared to the respondents who did not. Moreover, due to skin changes, as many as 80 people (15.7%) declared they had stopped using PPE. Conclusion: Our survey indicated that the use of PPE was associated with the appearance of new dermatoses and the exacerbation of existing skin diseases.

ObjectiveThe aim of this study is to evaluate the effectiveness of Six Sigma management in standardizing surgical hand disinfection practices among medical personnel.MethodsThe Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) framework was utilized to assess and enhance the accuracy and effectiveness of surgical hand disinfection. Factors contributing to low accuracy and a high defect rate in disinfection practices were systematically analyzed. Key issues identified included limited awareness of infection control protocols, insufficient knowledge of proper surgical hand disinfection practices, and inadequate oversight of surgical staff. Interventions based on this analysis included the use of text and video reminders, reinforcement of medical personnel training, implementation of enhanced camera-based monitoring and supervision, and the establishment of a reward-and-penalty evaluation system.ResultsPost-intervention analysis revealed that the accuracy of surgical hand disinfection among medical personnel increased from 42.94 to 82.97%, with surgeons demonstrating the greatest improvement, achieving a 47.70% increase. The overall defect rate decreased substantially, with the most notable reduction observed in incomplete hand coverage with disinfectant, which decreased by 2.75%. Additionally, the average number of bacterial colonies on the hands of medical staff decreased from 4.44 ± 2.51 CFU/cm2 to 2.68 ± 0.54 CFU/cm2, and the qualification rate improved markedly from 71.67 to 98.33%. All observed improvements were statistically significant.ConclusionThe application of Six Sigma management effectively enhances the accuracy and quality of surgical hand disinfection, reduces procedural defects, and enhances disinfection outcomes in clean surgical procedures.