Hand Hygiene Performance Research Articles

Knowledge and practice of hand hygiene among practicing physical therapists of Lahore after covid-19 pandemic

Background: Hand hygiene has become an important factor after Covid-19 pandemic. The practicing physical therapists are more prone to infections due to direct contact with patients. The knowledge and practice is therefore very important for them. Methods: This study is descriptive cross sectional. It was conducted among practising physiotherapist of CMH Hospital and private clinical setups of Lahore. Non probability convenient sampling was used for participant selection. Window SPSS 23.0 was used for statistical analysis. Results: The data was collected from 206 participants. 123 participants were males and 83 participants were females. In answer to if the participants received education of hand hygiene, 81 participants answered no and 125 answered in yes. In an another question about the use of alcohol based hand rub for hand hygiene 60 participants answered no and 146 participants answered yes. The total score for knowledge and practice of hand hygiene was 64 from question number 3-11. Question number 7 of the questionnaire consists of further 8 parts, that’s why the total score becomes 64. The mean score percentage was 70.59±16.94. In question 12 the participants were asked about who have given the idea to perform hand hygiene, 104 told that their manager, 89 told that their peer and 13 participants told that their patients remind them about hand hygiene. The participants faced some barriers in this regard e.g. out of product material, too busy in work, forget about hand hygiene etc. Conclusion: The study shows that most physical therapists of Lahore have better knowledge and practice of hand hygiene. Both male and female practicing physical therapists are well aware of the importance of hand hygiene. But few barriers such as non-convenient, out of product material influence in practicing hand hygiene.

State of infection prevention knowledge among healthcare professionals in Japan: a questionnaire survey analysis using text mining

Healthcare-associated infections (HAIs) are an important issue that needs to be continuously addressed in healthcare institutions, and healthcare professionals (HCPs) are expected to strengthen educational programmes on infection prevention. Although the incidence of HAIs in Japan has been decreasing, the actual state of knowledge on infection prevention among HCPs remains unclear. To clarify the actual infection prevention knowledge of HCPs in Japan. The study participants were 1158 HCPs working in healthcare institutions with frequent contact with patients (283 doctors, 591 nurses, 115 physical therapists, 97 radiologists, and 72 medical technologists). HCPs described the infection prevention behaviours they consciously adhered to via an online self-administered questionnaire. Data were analysed by text mining. Categories were extracted from the responses to reveal HCPs' infection prevention knowledge. More than half of the participants (64.9%) were aged > 40 years, and 48.1% had over 20 years of clinical experience. The majority of the participants were nurses (51.0%), 43.9% had a bachelor's degree, and 56.6% were female. Seven categories regarding infection prevention knowledge were extracted: "performing hand hygiene and gargling," "wearing personal protective equipment," "strengthening one's immunity," "protecting oneself and patients from infection," "distinguishing clean and unclean zones," "actions to prevent transmission to others in daily life activities," and "maintaining distance from others." These results suggest that most HCPs working in healthcare settings in Japan prioritize and adhere to standard precautionary measures, and that the low incidence of HAIs may be influenced by perceptions of the knowledge of "handwashing and gargling" among HCPs.

Guidelines in Practice: Surgical Attire.

Perioperative team members wear surgical attire when working in the OR. Wearing clean surgical attire is important to maintain a high level of cleanliness for patient safety. The recently updated AORN "Guideline for surgical attire" provides perioperative nurses with recommendations for wearing surgical attire in the semirestricted and restricted areas of the perioperative setting. This article discusses recommendations for laundering; head coverings; shoes; and identification badges, access cards, and personal items. It also includes a scenario describing compliance monitoring for an updated policy related to cleaning cell phones and performing hand hygiene after cell phone use. Perioperative nurses should review the guideline in its entirety and apply the recommendations for wearing surgical attire in the perioperative environment.

Indication-based and patient-based hand hygiene performance among nurses working at a university hospital.

The traditional method of monitoring hand hygiene (HH) based on specific indications does not ensure that HH is performed for all required indications during patient care. This study aimed to compare HH performance rates (HHPRs) based on specific indications versus overall patient care among nurses at a university hospital. The study retrospectively analyzed HH monitoring data for 1398 indications from 543 patients and 190 nurses. Observations were conducted continuously, tracking a single healthcare worker from before patient contact until the end of the contact within a 30-min period. The indication-based HHPR was found to be 89.1%, while the patient-based HHPR was 78.1%. In the context of patient-based HHPR, the lowest rates were observed among nurses in the emergency room (48.3%) and those with less than 1 year of work experience (66.7%). Moreover, the largest discrepancy between indication-based and patient-based HHPR was noted among emergency room nurses with less than 1 year of experience. This significant difference underscores the need for patient-based HH monitoring, particularly for nurses in emergency settings and those with limited experience.

The Relationship of Motivation with The Level of Nurses' Compliance in Performing Hand Hygiene in The Surgical and Internal Partition Areas of Raden Mattaher Hospital Jambi

Hand hygiene is a program carried out by WHO to overcome HAIs. The implementation of this program is influenced by various things such as nurse motivation and compliance. Efforts to prevent HAIs that health workers can take are to increase their ability and motivation by implementing standard precautions, namely practicing hand hygiene. Motivation is needed by nurses to comply with the implementation of hand hygiene. This study aims to determine whether there is a relationship between motivation and nurses' compliance in carrying out hand hygiene. The design of this research is descriptive correlative with a cross sectional approach. The sample in this study was taken using a total sampling technique, namely 71 nurses. The variables studied were motivation and compliance in carrying out hand hygiene. Data collection was carried out by distributing questionnaires and observation sheets. Data were analyzed using Spearman Rank Correlation with significance α≤0.05. The research results showed that of the 71 respondents who had good motivation, 44 (83.0%) respondents complied with hand hygiene and 9 (17.0%) respondents did not comply with hand hygiene. Respondents with moderate motivation were 18 (100.0%) respondents who did not comply with hand hygiene. Meanwhile, there were no nurses found with less motivation. The results of the analysis of the relationship between motivation and the level of nurse compliance in carrying out hand hygiene showed that the p-value was 0.01. There is a relationship between motivation and nurse compliance in carrying out hand hygiene. Most nurses have good motivation and are obedient in carrying out hand hygiene. However, there are still nurses who have moderate motivation and are not compliant in carrying out hand hygiene. Therefore, further efforts need to be made to increase nurses' motivation and compliance in carrying out hand hygiene.

Connecting Pathogen Transmission and Performance of the WHO’s ‘My 5 Moments of Hand Hygiene’ in a High-Fidelity Simulation

Background: The World Health Organization launched ‘Your 5 moments for hand hygiene’ to identify when healthcare workers should perform hand hygiene to reduce healthcare-associated infections (HAIs). Performing hand hygiene correctly is necessary to decrease pathogen transfer, though little research has assessed the effectiveness of all 5 moments. Methods: Registered nurses (n=42) participated in a standardized, one-hour high-fidelity patient care simulation that were recorded via a head-mounted camera. The simulation involved two patients, each requiring four clinical care tasks (e.g., indwelling Foley catheter insertion, stool sample collection). Transmission data was obtained from the simulations using four genetic variants of bacteriophage λ. Before each simulation, variants were applied to unique locations on two manikins: patient A’s wound, patient A’s stool, patient B’s groin, and patient B’s stool. After each simulation, we sampled the patients, nurse, and high-touch environmental surfaces to determined bacteriophage identity of positive samples. For each moment, hand hygiene performance was the total time the nurse practiced hand hygiene across opportunities over the total recommended time (15 seconds per opportunity). Positive samples were categorized as 1) nurse contamination, 2) patient critical site(s) contamination, 3) high touch surface contamination from the same patient, or 4) high touch surface contamination from the other patient. To compare nurse’s performance of each of the 5 moments, we used a Friedman test and then a Wilcoxon test for pairwise comparisons. To assess the relationship between the four types of transmission outcomes and hand hygiene performance of the 5 moments, we performed linear regressions and calculated 95% confidence intervals by bootstrapping the original cases. Results: Performance of moments 1 (Before patient contact: 9.49%), 4 (After patient contact: 13.11%), and 5 (After contact with patient’s surroundings: 13.66%) were significantly higher than moments 2 (Before clean or aseptic task: 2.72%) and 3 (After bodily fluid exposure: 4.22%; p < 0 .05). Moment 2 perfomance, furthermore, was significantly lower than moment 3 (Figure 1). Only moment 2’s performance was significantly related to transmission; specifically, performance was negatively related to critical site contamination (B= -0.03, CI 95%: -0.06 – -0.01); Table 1. Conclusions: Moment 2performance was the lowest of all 5 moments and was the only moment that demonstrated evidence of relationship with pathogen transmission, specifically critical site contamination. Of all the 5 moments, this moment is most directly related to HAIs. Further research should investigate why moment 2 performance is so low.

Staff Perspectives on Barriers & Facilitators to Meeting Hand Hygiene Goals in a Multicenter Academic Hospital System

Background: Proper hand hygiene is the most important practice to reduce the transmission of infections in healthcare settings. Despite this, healthcare institutions continue to struggle to achieve and maintain high rates of hand hygiene compliance among healthcare workers with some studies estimating national healthcare worker hand hygiene compliance to be approximately 50%. Methods: We conducted an anonymous one-time survey of our Lifespan Hospital System employees to evaluate barriers and facilitators to performing hand hygiene as well as interventions to improve hand hygiene compliance. The survey was designed with guidance from the Consolidated Framework for Implementation Research and input from Lifespan infection prevention staff. Result: Over four weeks 985 (6%) Lifespan employees completed the survey. Figure 1 shows the aggregate results of the first 4 survey questions which focused on hand hygiene infrastructure at Lifespan, including availability of sanitizer, staff to manage hand hygiene supplies, and educational materials/reminders. One significant finding was >70% of respondents reported that they either did not know if their unit/department has a person assigned to replace/monitor hand hygiene supplies, or if so, who that person is. We also asked employees to rate how effective different interventions would be at improving hand hygiene compliance. Figure 2 shows of five proposed interventions, three were rated as either “moderately effective” or “very effective” by >50% of respondents. These included displaying hand hygiene instructions, making hand hygiene data available to employees, and displaying materials/reminders promoting hand hygiene. There were also 977 free-text responses regarding “barriers or facilitators to proper hand hygiene”. Major barriers identified were a lack of staff to monitor and refill supplies, slow replacement of hand hygiene products, lack of sanitizer dispensers and sinks, inconsistency of sink location and dispenser placement, lack of hand hygiene reminders/educational materials, time constraints, skin irritation from sanitizer, and an inability to have dispensers in behavioral health units. Survey responses led us to enhance the following: educational materials and reminders in work areas; staff education; leadership involvement in hand hygiene initiatives; routine auditing and feedback; conveniently placed sanitizer dispensers and sinks at the point of care; and making hand hygiene compliance data readily available to staff. Conclusion: This survey identifies important barriers and facilitators to achieving high rates of hand hygiene compliance among healthcare workers and provides the basis for interventions aimed at improving hand hygiene compliance in a large multicenter academic hospital system.

Assessing the incorporation of the 'Five Moments for Hand Hygiene' into nursing procedure textbooks

AimOur aim was to conduct a thorough comparison between the hand hygiene information included in international nursing textbooks and the Slovenian nursing textbook's equivalent content as it relates to nursing procedures. BackgroundHand hygiene practices are crucial in preventing healthcare-associated infections, which affect millions of patients annually. The idea behind "Five Moments for Hand Hygiene" is to encourage assessing success and boosting self-efficacy. DesignComparison of hand hygiene content in international nursing textbooks with the content in a Slovenian nursing textbook. MethodsA study was conducted between March 2023 and March 2024 to compare hand hygiene content in international nursing textbooks. The study included textbooks from the USA and UK, as well as Slovenian (SI) textbooks. The final phase involved comparing hand hygiene performance practices against the WHO Five Moments for Hand Hygiene. ResultsThe study reviewed 470 nursing procedures across three textbooks, identifying four common ones: female indwelling urinary catheterisation, small-bore feeding tube insertion, enema administration and subcutaneous injections. The USA textbook had the highest number of steps, while the UK textbook had the lowest. Clean protective gloves are not recommended for all nursing procedures, only for small-bore feeding tube insertion and enema administration. The US textbook omitted 12 steps for the female indwelling urinary catheter procedure, while the UK textbook included 10 steps. The SI textbook omitted 8 steps. ConclusionsHand hygiene is crucial for healthcare infections prevention and control. The study found differences in the frequency of hand hygiene in these nursing procedures. WHO's Five Moments for Hand Hygiene guidelines are not universally accepted, with inadequate hygiene often observed before patient contact. Future research should review foreign textbooks and update existing ones.

Evaluation of the appropriateness of control measures related to nosocomial transmission of multidrug-resistant microorganisms within the SS Multipurpose Intensive Care Unit: observational study

Background: Healthcare-Associated Infections (HAIs), by definition, occur 48 hours or more after admission or within 30 days after discharge or surgical procedure; they represent a significant challenge for the healthcare system due to their prevalence in Italy and the involvement of multi-drug resistance. Intensive Care Units (ICU) exhibit the highest prevalence of such infections due to lapses in adherence to safety protocols. The primary cause of hospital-acquired infections is poor adherence to guidelines for the prevention and control of these infections. This study aims to evaluate infection control measures in a mixed ICU. Materials and Methods: a cross-sectional observational single-center study was conducted in the Mixed ICU at the University Hospital of Alessandria. The study used an assessment tool based on the DVA 91 rev 03 issued on 07/22/22. This tool provides guidance on isolation type (airborne, contact, droplet), patient accommodation, care measures, cleaning and disinfection protocols, patient transportation, and visitor management. Results: overall, 220 observations were included, primarily involving nurses (75.4%) and female personnel (65.9%), with a mean age of 35.8 years and a median length of service of 36 months in the Mixed ICU. Notably, all observations were made on patients in contact isolation. In 199 observations (92.6%), healthcare providers performed hand hygiene immediately after glove removal. Conclusions: the findings highlight a strong adherence to infection control protocols at Alessandria Hospital-University. These efforts promote a safety culture among healthcare providers, ensuring the effective implementation of preventive measures.

A simulation study of touch-free automatic alcohol-based handrub dispensers on hand hygiene disruption in healthcare settings

Automatic dispensers of alcohol-based handrub (ABHR) have been widely adopted in healthcare facilities to maintain hand hygiene (HH). A proper supply of energy and refill is crucial to ensure uninterrupted access to hand sanitizing and minimize workflow disruption and inefficiencies. Various energy design and refill replenishment technologies have emerged with promising potential to eliminate HH disruptions. However, there is a lack of quantitative studies assessing the design impact on hand hygiene performance in healthcare settings. In this paper, we employ data-driven discrete-event simulation (DES) to evaluate the long-term performance of various energy designs of automatic dispensers in healthcare facilities. We analyze 7 years of historical usage data from 4 US hospitals and identify the usage patterns, which serve as the input traffic for our simulation model. We then estimate the workflow disruption caused by different types of dispensers over a 6-year period, in terms of the number of missed HH opportunities, battery replacements, and duration of downtime. The simulation results suggest that the differences in performance are significant among dispenser types. In high usage, the number of missed HH opportunities caused by refill depletion ranges from 403.1 to 1232.4, and total downtime ranges from 0 to 96.3 h. Implementing proactive maintenance measures, such as service refill alerts, can greatly reduce the chances of ABHR depletion, resulting an 81.6 % decrease in HH disruptions for a single dispenser in high usage. Therefore, healthcare facilities should consider the variations in dispenser design, including the energy management system. They should also carefully study dispenser usage patterns to implement optimized policies and practices for ABHR refill maintenance to minimize overall missed HH opportunities.

Knowledge & Practice of Nurses Regarding Central Line-Associated Bloodstream Infection & Prevention

Background: Central venous catheters (CVCs) are crucial in medical care but pose a significant risk for bloodstream infections, leading to increased morbidity, mortality, and healthcare costs. Effective knowledge and practices among nurses are essential for preventing central line-associated bloodstream infections (CLABSI). Objective: To assess the knowledge and practices of nurses regarding the prevention of CLABSI at Sughra Shafi Medical Complex Narowal and identify factors influencing these practices. Methods: This descriptive cross-sectional study involved 200 staff nurses selected from a population of 400 using a non-probability convenient sampling technique. Data were collected via a self-administered questionnaire covering demographics, professional experience, and specific knowledge and practices related to CLABSI prevention. The study was conducted over six months, and data analysis was performed using SPSS version 25, with chi-square and Fisher exact tests applied to determine associations between variables. Ethical approval was obtained, and all participants provided informed consent. Results: The study included 200 nurses, predominantly female (90%), with ages ranging from 18 to 37 years (mean age 25 ± 3.9 years). Professional experience varied, with 36.5% having 1-5 years, 41% having 6-10 years, and 22.5% having 11-15 years of experience (mean experience 7.31 ± 3.0 years). Knowledge assessment revealed that 68.5% knew CVCs should be routinely replaced, and 88.5% were aware of disinfecting catheter insertion sites with 10% povidone-iodine. However, only 43% regularly performed hand hygiene before inserting a central line, and 48.5% used chlorhexidine for skin preparation. Conclusion: While nurses demonstrated satisfactory knowledge regarding CLABSI prevention, their practices were inadequate, indicating a need for enhanced training and adherence to infection prevention protocols.

Overview of A Nurse In Implementing 5 Moments of Hand Washing in the Prevention of Nosocomial Infection

Behaviors to prevent the spread of disease from person to person or from equipment to person can be carried out by placing a barrier between the microorganism and the individual (patient or health worker). The barrier can be physical effort in the form of washing hands. There are "5 moments" when health workers must perform hand hygiene. The aim of this research is to describe the implementation of the 5 moments of hand washing by nurses in the Bougenville ward of RSUD Dr. H. Soewondo Kendal. The type of research used is quantitative descriptive research. The sample in this study were nurses in the Bougenville room on the first and second floors of RSUD Dr. H. Soewondo Kendal as many as 31 respondents with a sampling technique using total sampling technique. The instruments used were questionnaires and observations. The questionnaire uses the standardized SPO KARS 2017. The research analysis used is univariate analysis. The results of research on the implementation of 5 hand washing moments, the majority of respondents always wash their hands before contact with patients, 23 (74.2%), nurses always wash their hands before carrying out aseptic procedures, 29 (93.5%), nurses always wash their hands after being exposed to body fluids. 29 patients (93.5%), 29 (93.5%) nurses always wash their hands after contact with patients, 29 (93.5%) nurses always wash their hands after contact with the patient's environment.

Nutritional care practices for children from 6 to 24 months old by Cham ethnic mothers

Background: This study aims to explore the nutritional care practices for children from 6 to 24 months old by Cham ethnic mothers in Tan Chau town, An Giang province in 2018. Methods: A cross-sectional study was conducted on Cham ethnic children aged from 6 to 24 months and their mothers living in Tan Chau town, An Giang province. Results: The rate of mothers practicing proper and sufficient prenatal care during pregnancy is 74.4%; the rate of mothers engaging in lighter work than before pregnancy is 64.2%; the rate of mothers eating more than before pregnancy is 72.2%; the rate of mothers taking iron supplements during pregnancy is high at 85%. Practices regarding the timing of weaning children are not good, with 36.8% of mothers weaning children at the wrong time. Practices for feeding children supplementary foods are relatively good: 90.7% of mothers feed their children at the right time, however, the rate of mothers providing children with a complete range of food groups is only 23.0%. Maternal care practices for sick children have many shortcomings, with 81.7% of mothers feeding children incorrectly when they have diarrhea, and only 38.4% of children receiving oral rehydration solution (ORS) when they have diarrhea. Personal hygiene practices of the mother and child care are not good, with 24.3% of mothers not properly performing hand hygiene for themselves and their children. Conclusions: We need to strengthen propaganda and consulting work for each group of subjects, especially the Cham ethnic people, on nutritional care practices for children from 6-24 months old.

Conjunctivitis: A Guide of Etiology, Morphology, Care, and Prevention

Conjunctivitis is a highly contagious infection caused by bacteria, viruses or allergies. Seasonal peaks are seen for various types of conjunctivitis. Effective infection management includes isolation, thorough cleaning and proper hygiene. Performing hand hygiene frequently is of utmost importance to prevent cross-infection and self-infection

Nursing Students Knowledge and Practice Regarding Handwashing in Riyadh Elm University: A Cross-Sectional Survey

Hand hygiene is one of the most important procedures performed in health care institutions by all the staff providing health care to patients. Less compliance to hand hygiene and lack of performing hand hygiene among students when going to the patient ward during their clinical rotation in the hospital provoked to focus on this study. Descriptive research design was utilized under cross-sectional survey. The data was collected by both questionnaires to assess the nursing student’s knowledge and checklist to assess the students practice level. The adapted questionnaire was pre-tested before the conduct of the study. A number of 27 nursing students represent the total sample of the study. They were selected using convenience sampling technique. Once the data were collected, it was analyzed with statistical treatment using SPSS version 22.0. Main findings have shown that nursing students were highly knowledgeable in performing handwashing during recommended situations and handwashing is a habit to their personal life. Completing the task than performing hand hygiene was the area need to focus among nursing students. There is a significant relationship between demographic characteristics and knowledge and practice level.

Evaluation of Social-Cognitive Determinants of Patients’ Hand Hygiene Decisions and the Role of Mental Health in a Cross-Sectional and a Longitudinal Study of German Patients

Patients’ effective hand hygiene helps to reduce healthcare-associated infections and prevents the spread of nosocomial infections and communicable diseases, such as COVID-19. Accordingly, this study aimed to describe effective hand hygiene decisions based on the Health Action Process Approach (HAPA) and whether this pattern is invariant for mental health. Data were collected cross-sectionally from patients who had previously been admitted to a hospital (Nstudy 1 = 279; study 1) and longitudinally from psychosomatic rehabilitation patients (Nstudy 1 = 1073; study 2). The fit of the HAPA framework and changes in hand hygiene decisions regarding compliance, social-cognitive variables of the HAPA, and mental health status were examined. The results revealed that the trimmed HAPA framework fitted the data well (χ2 = 27.1, df = 12, p < 0.01, CMIN/df = 2.26, CFI = 0.97, RMSEA = 0.08). According to multi-group structural equation modeling, the HAPA model with hand hygiene behavior was found to be invariant regarding mental health. To conclude, the trimmed HAPA framework was revealed to be a generic framework for explaining social-cognitive processes relating to hand hygiene decisions. Therefore, helping individuals to perform hand hygiene recommendations requires intention formation and bridging the intention–behavior gap. This can be undertaken by promoting planning and self-efficacy. All processes appear generic to participants with and without mental health challenges.

Nurses' knowledge and attitudes towards hand hygiene in Aceh, Indonesia: A correlational study among surgical nurses

This study aims to thoroughly examine nurses' knowledge and attitudes about hand hygiene and investigate how these factors are related. Conducted in a hospital environment, the research aims to gather detailed information to help develop better hand hygiene practices among nurses. Healthcare-associated infections (HAIs) pose a global issue, impacting numerous people each year. However, consistent hand hygiene can greatly reduce these infections. Nurses are vital in preventing HAIs, and this study looks at the hand hygiene behaviors of thirty-three surgical nurses. The research involved collecting data through three questionnaires and analyzing it with the Pearson correlation test. The results revealed that the average knowledge score of the nurses was 11.6, and their average attitude score was 16.33. There was a strong correlation (r=0.688) between the nurses' knowledge and their attitudes towards hand hygiene practices. Moreover, a significant positive correlation (ρ-value of 0.000) was observed, indicating a meaningful relationship between knowledge levels and attitudes towards hand hygiene. The findings suggest that enhancing knowledge about hand hygiene results in a more positive attitude towards its practices. The role of the hospital ward manager is crucial in maintaining proper hand hygiene among staff. As a role model, supervisor, and evaluator, the ward manager significantly influences awareness and adherence to good hand hygiene practices. Additionally, the hospital should provide adequate support and resources to enable staff to perform hand hygiene effectively.

Infection Control Status of Hand Hygiene After Treatment of Contaminated Areas of Dental Workers

Objective: For infection control, dental workers' awareness of non-risk instruments and related infection control protocols commonly used in dental treatment or medical institutions was investigated, and infection control status was studied. Methods: This study involved 141 dental workers at S dental hospitals, Y dental clinics, I dental clinics, and H dental clinics in Gwangju and Gyeonggi-do. The study participants are G.With the power 3.1 program, 141 people were calculated with an effect size of 0.3, a significance level of 0.05 and a power of 0.95. After visiting the dentist in person to explain the purpose of the study and how to fill out the questionnaire, it was retrieved after self-filling. The questionnaire was 13 questions, and the alpha of the reliability statistic Cronbach was .083, indicating high reliability. Results: In the descriptive statistics of univariate variance analysis of hand hygiene performance when moving contaminated areas, the younger the age, the lower the hand hygiene performance when moving contaminated areas. Conclusion: Conducting hand hygiene after contact with age and contaminated areas. In wearing hand hygiene gloves, the F statistic is 2.698, significance probability .002, which is significantly explained at significance level .05. In other words, hand hygiene after contact with age and contaminated areas. Wearing hand hygiene gloves was found to be at a low level.

A Study of Insulin Injection Practices in Al Ahsa’s Diabetic Population

Background: Diabetes Mellitus (DM) is a global health problem. Saudi Arabia is one of the leading ten countries worldwide with a high prevalence rate close to 24%. Improper insulin injection technique is a common phenomenon. Aim: The purpose of this study was to explore how participants were performing insulin injections and the factors associated with those practices. Methods: A cross-sectional study using a questionnaire-based survey was carried out at two locations in Al Ahsa, Saudi Arabia. These locations included: (1) primary healthcare centers, (2) the Diabetic Center at King Fahd Hospital. The inclusion criteria included nonpregnant patients aged 18 years or older with type 1 or type 2 diabetes injecting insulin using an insulin pen or insulin syringes. Results: Four hundred and fourteen diabetic patients participated in the study. Age was subcategorized into three age groups, and the most prevalent age group was between 18 and 28 years 192 (46.4%). In terms of gender, 293 (70.8%) of patients were female. A total of 219 (52.9%) had a college education. As for diabetics, 250 (60.4%) had type 1 diabetes. In terms of how long they have used insulin injections as a diabetes treatment, 159 (38.5%) have used it for less than five years. In terms of how many injections they use per day, 139 (33.6%) reported that they use three injections or more. In regards to keeping insulin in the refrigerator, 39 (9.4%) answered never, while 89 (21.5%) answered sometimes. In regards to performing hand hygiene before injection, 64 (15.5%) answered never, while 175 (42.3%) answered sometimes. In terms of checking the expiration date of insulin bottles, 44 (10.6%) never do so, whereas 175 (42.3%) check it on occasion. The number of participants with good practices was around one-third 149 (36%), while the number of participants with bad practices was 265 (64%). Conclusion: There was a low proportion of participants who frequently practiced insulin injections appropriately in this study. Patients should still be educated about the crucial injecting practices. There were unsafe insulin injection practices involving insulin pens and insulin syringes. It is important to pay more attention to the patient’s unsafe practices.

Healthcare Workers' Adherence and Attitudes Toward the Adherence to COVID-19 Precautionary Guidelines Post-Vaccination: A Cross-Sectional Pilot Study.

Healthcare workers (HCWs) have shown increased adherence to infection control practices during the COVID-19 pandemic. However, there is a need to assess their adherence to and attitude toward COVID-19 guidelines after being vaccinated. The purpose of this pilot study is to assess the adherence to and attitudes toward the adherence to COVID-19 guidelines among HCWs who have been vaccinated. A retrospective cross-sectional design was employed. One hundred and eight participants were recruited via email from a medical center in the Midwest United States. The participants completed online surveys measuring the level of adherence to and attitudes toward the adherence to COVID-19 guidelines. The response rate was 5.4%. Most participants were female (73.1%) and white (82.4%). The participants adhered to COVID-19 guidelines 79.7% of the time. The most frequently followed guidelines were performing hand hygiene, wearing a respirator or well-fitting mask in areas where patients may be present, and wearing eye protection when entering the room for a patient with suspected or confirmed COVID-19 infection. The least performed precautions were performing COVID-19 testing after exposure to a suspected or confirmed COVID-19 case and maintaining social distancing. There was a significant decrease in the perceived importance of adherence to COVID-19 precautions post-vaccination (p <.001, 95% CI [-0.78, -0.35]). The increased perception of safety after receiving COVID-19 vaccination may negatively influence HCWs' adherence to COVID-19 precautionary guidelines. Continuous education and monitoring of HCWs' safety practices are important to influence HCWs' attitudes to adhere to COVID-19 precautions, particularly after vaccination.