Hand Hygiene Practices Research Articles

Normalization of deviance in pediatric hospital: perception of health workers.

To know the perception of health workers about the phenomenon of normalization of deviance in a pediatric hospital. Exploratory, descriptive, and qualitative study conducted in a public pediatric hospital in northeastern Brazil in 2021. An in-depth interview was applied to 21 health workers, submitted to Thematic Categorical Content Analysis in the MAXQDA® Software. 128 context units emerged from the content analysis. These data were presented in three analytical categories, which address conceptions about normalization of deviance, examples and contributing factors. The omission of the practice of hand hygiene and the correct use of personal protective equipment,and turning off alarms stand out as the main deviance perceived by health workers. As contributing factors, human factors and organizational factors prevailed. Workers perceive the normalization of deviance as negligence, recklessness, and violations of good practices, with consequences for patient safety.

Reduced norovirus epidemic follows increased sales of hand hygiene products in Japan, 2020–2021

During the recent emergence of COVID-19, an increased practice of hand hygiene coincided with the reduced incidence of the norovirus epidemic in Japan, which is similar to experience with the pandemic flu in 2009. We investigated the relationship between the sales of hand hygiene products, including liquid hand soap and alcohol-based hand sanitizer, and the trend of norovirus epidemic. We used national gastroenteritis surveillance data across Japan in 2020 and 2021 and compared the base statistics of incidence of these two years with the average of the previous 10 years (2010-2019). We calculated the correlations (Spearman's Rho) between monthly sales of hand hygiene products and monthly norovirus cases and fitted them to a regression model. In 2020, there was no epidemic, and the incidence peak was the lowest in recent norovirus epidemics. In 2021, the incidence peak was delayed for five weeks to the usual epidemic seasons. Correlation coefficients between monthly sales of liquid hand soap and skin antiseptics and norovirus incidence showed a significantly negative correlation (Spearman's Rho = -0.88 and p = 0.002 for liquid hand soap; Spearman's Rho = -0.81 and p = 0.007 for skin antiseptics). Exponential regression models were fitted between the sales of each hand hygiene product and norovirus cases, respectively. The results suggest hand hygiene using these products is a potentially useful prevention method against norovirus epidemics. Effective ways of hand hygiene for increasing the prevention of norovirus should therefore be studied.

Indian Adults and Covid-19 Scenario

In order to understand the knowledge and practices used by the selected respondents in adopting a new normal to resist the COVID-19 pandemic age, the current study, titled Knowledge and Practices towards COVID-19 of the People of Ahmedabad City of Gujarat State, was conducted. 200 respondents from Ahmedabad City, aged 21 to 58, were chosen using a convenient sampling method. An online questionnaire using Google Forms was designed and executed using different social platforms such as email, WhatsApp, and text messages. In the study, descriptive statistics such as mean and standard deviation for continuous variables and frequency and percentages for discrete variables were used. Results of this study showed that social media was the most commonly accessed source of information on COVID-19 and that a large majority of respondents had greater access to information about it. Further, the majority of the respondents had a higher level of knowledge and were well-informed on the signs and symptoms, the spread of the disease, and preventive measures, but they were only partially or incorrectly informed about the recommended hand hygiene practices and risk factors that could increase the virus’s ability to spread. Nevertheless, more than half (54%) of the responders had inadequate COVID-19 practices. With regard to the variables of education and occupation, there were significant disparities in the respondents’ practices. The results of this study could serve as a baseline for NGOs, government officials, and other stakeholders as they reform and rebuild risk communication programs for such highly contagious diseases.

Toxocariasis in Ghanaian neighbourhoods: a need for action

BackgroundAnimal reservoirs of Toxocara spp., a neglected parasitic infection, are frequently found in many Ghanaian neighbourhoods. Despite various interactions occurring between these animals and humans which sustain zoonosis, not much focus has been directed at disease surveillance in Ghana, necessitating this study. MethodsThe study was cross-sectional. It combined the collection of biological samples with the survey approach. The study used purposive and convenience sampling techniques to collect data from eligible participants in the Greater Accra region of Ghana. Besides the collection of biological samples from animals which were processed using molecular techniques, semi-structured questionnaires were administered to the pet owners. ResultsIn sum, 32.2% (95% CI, 27.6%–37.0%) of the targeted animals were positive for Toxocara canis, with most of the cases being found in dogs and rodents. Among the 204 rodents, more Praomys tulbergi were positive for this parasite compared to the others. From the survey, some risk factors culminating in high disease exposure were identified: more than one-third of pet owners did not deworm their pets although about a fourth shared bed with them. In addition, many respondents’ kids played with these pets but not all supervised them to practice hand hygiene. Also, a good number of pet owners confirmed the frequent exposure of their pets to rodents. ConclusionsThe relatively high prevalence of T. canis recorded in animals and the increasing exposure of humans to this parasite point to a higher risk for human toxocariasis. Furthermore, T. canis found in cats cannot be ignored and merits further investigations. For Ghana to achieve SDG 3 by 2030, priority must also be placed on neglected diseases which calls for an integrated approach to disease surveillance and a redirection of research focus using the one health concept.

Determinan Peran Kepemimpinan Kepala Ruang Terhadap Kepatuhan Perawat dalam Melaksanakan Hand Hygiene di RSUD Cut Meutia Aceh Utara

Nurses are human resources who influence the quality of nursing care in optimal health services. Professional nurses not only manage individual patients but the whole process to be able to complete tasks in providing nursing care by minimizing the risk of infection in the hospital. Hand hygiene or hand washing practices are currently considered as one of the most important key elements in infection prevention efforts. The practice of hand hygiene has sufficient scientific evidence that when done properly it can significantly reduce the risk of infection transfer in health facilities. The role of the head of the room is very important in empowering nurses to increase nurse compliance in implementing hand hygiene in hospitals. This study aims to analyze the leadership role of the head of the room towards nurse compliance in carrying out hand hygiene at Cut Meutia Hospital, North Aceh. The population of this study were all practicing nurses who served in the inpatient rooms of the Cut Meutia North Aceh Hospital, totaling 90 nurses. The results showed that the description of the interpersonal role of the head of the room in carrying out hand hygiene was good 52 (57.8%), the role of the head of the room in carrying out hand hygiene was good 65 (72.2%) ) and the decision-making role of the head of the room in carrying out hand hygiene less than 50 (55.6%). Hospital management has an obligation to improve the ability of the head of space in carrying out his role in improving health services.

Questionnaire-Based Study Evaluating the Hand Hygiene Practices and the Impact of Disinfection in the COVID-19 Pandemic on Hand Skin Conditions in Poland

During the COVID-19 pandemic, disinfection became an integral part of everybody's life in order to avoid spreading the coronavirus. In 2021, an original anonymous online survey was carried out. The questions concerned the usage of disinfectants. The study population included 56 subjects diagnosed by a physician with hand eczema (HE-derm group) and 114 subjects with no hand skin disease diagnosed by a specialist (non-derm). The HE and non-HE groups were distinguished. Nearly 80% of the HE group, and 10% of the non-HE group, experienced worsening of hand skin lesions caused by increased skin disinfection. HE-group respondents more often declared the occurrence of new hand skin symptoms, over 80% of the subjects of this group had more than 1 new symptom (compared to nearly 40% of the non-HE group). Exacerbations of the skin disease were more frequently observed by the HE group during the pandemic. There was a statistically significant decrease of the quality of life in the HE group compared to the non-HE group during the pandemic. The COVID-19 pandemic caused an increase in the prevalence of hand skin symptoms and deterioration of the skin condition. Education on appropriate disinfection techniques and skincare, as well as early dermatological intervention, might allow us to limit the development of hand skin diseases.

Personal and Household Hygiene Measures for Preventing Upper Respiratory Tract Infections among Children: A Cross-Sectional Survey of Parental Knowledge, Attitudes, and Practices.

Personal and household hygiene measures are important for preventing upper respiratory tract infections (URTIs) and other infectious diseases, including coronavirus disease 2019 (COVID-19). An online survey recruited 414 eligible parents in Hong Kong to study their hygiene knowledge, attitudes, and practices (KAPs) regarding the prevention of URTIs among their children. The average knowledge score was high (10.2/12.0), but some misconceptions were identified. The majority of the participants agreed that good personal hygiene (93.5%) and good environmental hygiene (92.8%) can prevent URTIs. The average score for hand hygiene practices was high (3.78/4.00), but only 56.8% of the parents always performed hand hygiene before touching their mouths, noses, or eyes. In terms of environmental hygiene, only some household items were disinfected with disinfectants (door handles in 69.8% of the households, toilet seats in 60.4% of the households, the floor in 42.8% of the households, dining chairs in 24.2% of the households, and dining tables in 20.5% of the households). A higher knowledge score was associated with parents having tertiary educational levels or above, working as healthcare professionals, living in private residential flats or staff quarters, or having household incomes of HKD 70,000 or above. The results of multiple regression analyses also indicated that parents who were healthcare professionals and with higher household income had a better parental knowledge of hygiene measures after adjusting the attitude score. For hand hygiene, parents who achieved higher attitude scores obtained higher practice scores. Under the fifth wave of the COVID-19 epidemic, there were some misconceptions regarding hygiene among parents. Any health promotion program should target parents regarding taking proper personal and household hygienic measures, especially for those who had relatively lower socio-economic status and/or from a non-healthcare background. Motivating attitudes toward hand hygiene can lead to better practices.

Hand eczema prevalence among healthcare workers during COVID-19 pandemic – a systematic review

Introduction The globe is currently experiencing a new pandemic due to the introduction of the SARS-CoV-2 strain of the human coronavirus. The virus infects people and causes COVID-19, a lung condition that can be fatal in susceptible people and is characterized by fever, pneumonia, and shortness of breath. The prevalence of hand eczema among healthcare professionals working in COVID-19 units has grown, and it has been linked to increased hand sanitation habits. Aim of the study The purpose of the study was to examine the prevalence of hand eczema as a consequence of more intensive hand hygiene among healthcare workers during COVID-19 pandemic. Materials and methods A search was conducted using PubMed and Google Scholar databases. Articles were searched in English using the following key words: hand eczema; hand dermatitis; atopic dermatitis; COVID-19; SARS-CoV-2. Results Healthcare workers developed hand eczema more frequently in COVID-19 outbreak. The risk of hand eczema was raised by frequent use of hand hygiene products, alcohol-based hand sanitizers, wearing gloves, previous atopic dermatitis history and female sex gender. Due to excessive hand hygiene the natural skin barrier function was impaired, leading to hand eczema. The use of preventive skincare products can lower the risk of hand eczema development. Conclusion Findings demonstrated positive correlation between hand eczema prevalence among healthcare professionals and COVID-19 pandemic. Hand washing and the use of disinfectants disrupt the natural skin barrier function, leading to allergic and irritating hand eczema. In order to continue practicing hand hygiene during the continuing pandemic, proper prevention strategies and education should be implemented.

Inequality of handwashing practice using antimicrobial agents in Bangladesh: a household level analyses

ObjectivesAbout 2.3 billion individuals worldwide are still deprived of the amenity of handwashing with antimicrobial agents. The progress of handwashing with antimicrobial agents in Bangladesh is relatively slower than in many developing countries. The objective of this study was to capture the inequality of the prevalence of handwashing with antimicrobial agents and to identify the factors that are potentially contributing to socio-economic inequalities of handwashing practice in Bangladesh. Study designCross-sectional study. MethodsThe present study used the nationally representative cross-sectional data from the latest Bangladesh Demographic and Health Survey (BDHS) 2017–18. A total of 19,457 households were included in the analysis of this study. A regression-based decomposition method was applied to assess the socio-economic contributors of inequality. ResultsThis study showed that only 38% of Bangladeshi households wash their hands with antimicrobial agents while a pro-rich socio-economic inequality was observed. Household's wealth index was responsible for about 46% of the overall inequality of handwashing with antimicrobial agents while the type of place for handwashing variable contributed 38% of total inequalities. Hygienic toilet facilities (12%) and exposure to mass media (7.4%) are other determinants of total inequalities of handwashing with antimicrobial agents. ConclusionsDespite recent declines in attributable mortality, handwashing with antimicrobial agents remains an important determinant of public health problems in many developing countries like Bangladesh. The regular programs aimed at promoting best hand hygiene practices and ensuring the availability of the necessary infrastructure at the community level will be important measures to eliminate this inequality at the population level.

Infections in Critically Ill Children.

Health care-associated infections (HAI) directly influence the survival of children in pediatric intensive care units (PICU), the most common being central line-associated bloodstream infection (CLABSI) 25-30%, followed by ventilator-associated pneumonia (VAP) 20-25%, and others such as catheter-associated urinary tract infection (CAUTI) 15%, surgical site infection (SSI)11%. HAIs complicate the course of the disease, especially the critical one, thereby increasing the mortality, morbidity, length of hospital stay, and cost. The incidence of HAI in Western countries is 6.1-15.1% and in India, it is 10.5 to 19.5%. The advances in healthcare practices have reduced the incidence of HAIs in the recent years which is possible due to strict asepsis, hand hygiene practices, surveillance of infections, antibiotic stewardship, and adherence to bundled care. The burden of drug resistance and emerging infections are increasing with limited antibiotics in hand, is still a dreadful threat. The most common manifestation of HAIs is fever in PICU, hence the appropriate targeted search to identify the cause of fever should be done. Proper isolation practices, judicious handling of devices, regular microbiologic audit, local spectrum of organisms, identification of barriers in compliance of hand hygiene practices, appropriate education and training, all put together in an efficient and sustained system improves patient outcome.

Increased Frequency of Hand Hygiene and Other Infection Prevention Practices Correlates with Reduced Surgical Wound Infection Rates in Spinal Surgery during the COVID-19 Pandemic.

Due to the COVID-19 pandemic outbreak, many changes were done in the hospital practice, and new guidelines were issued in order to contain the infection spread. One of the most common measures is represented by a correct and frequent hand washing. Recently, an association between increased adherence to hand hygiene (HH) protocols and reduction in hospital infections was documented however no studies about the surgical wound infection rate were reported in the Literature. The present study represents a multicentric retrospective epidemiological study. The HH compliance rate was recorded through direct observations by trained nurses, 24 h a day. The primary outcome was HH compliance rate. The association of HH with spinal surgical wound infections was the secondary outcome. We reported a compliance to HH practices during the pandemic period of 85.2% compared with 57% observed during 2019. Our analysis showed an overall surgical wound infection reduction of 66.6% during the hospital stay in the pandemic period. Hand hygiene has always been considered one of the most effective, reproducible and low-cost weapons to deal with hospital infections. The good health habits acquired during the COVID-19 pandemic should be maintained even after the virus is eradicated.

Assessment of Hand Hygiene Practices and Barriers to hand Hygiene among Healthcare workers of Government Medical College Hospital Jammu

Introduction: Hand hygiene is most effective interventions to reduce spread of pathogens and prevent Hospital Acquired Infections (HIAs). Compliance of healthcare workers with hand hygiene practices is vital in preventing transmission of HIAs.Aims: To assess practices and barriers of hand hygiene among healthcare workers of GMCH Jammu.Methodology: Cross sectional study was conducted among healthcare workers of Government Medical College Hospital Jammu. Simple random sampling was used to interview 250 participants. Data was collected using pretested, validated and semi structured questionnaire. Details like products used for hand hygiene, moments of hand hygiene, barriers to hand hygiene practices and knowledge about hand hygiene were asked. Appropriate statistical tests were appliedResults: Out of 250 healthcare workers majority were using soap and water 203(81%) and alcohol based sanitizers 202(80%).Majority 234(93.6%) were always performing hand hygiene after touching blood, body fluids and secretions,222(88.8%) and after contact with the patients but only 138(55.2%) were following hand hygiene practices while switching from one patient to other.Most common barrier to wash hands was lack of soap/water115(46%) and inconvenient location of sinks 112(44.8%). Only 117(46.8%) were following six steps of hand wash. The association between designation of health care worker and steps of handwashing was found to be statistical significant. Conclusion: Observed compliance to hand hygiene practices is low. There is lack of knowledge to perform six steps of hand washing and lack of facilities to maintain hand hygiene.

Non-Pharmaceutical Intervention Strategies to Respond to the COVID-19 Pandemic: Preference Ranking Method

One of the hot topics of discussion today is coronavirus disease 2019 (COVID-19).  The disease is easily transmitted from one person to another person. However, there are no specific drugs that can alleviate the disease thus non-pharmaceutical intervention strategies is a good option. This paper aims to apply the Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE) method to outrank the intervention strategies. A case study is presented where five experts were invited to rate ten alternatives and ten criteria using linguistic scales. Spreadsheet software and PROMETHEE-GAIA software were employed to establish outranking results and to provide evidence on the vigorousness of the outranking results. The final outranking indicates that the most and the least preferred intervention strategies are alternative A1 (lockdown/quarantine) and alternative A10 (Practice of hand hygiene) respectively. The outranking results are further analyzed with distribution analysis and weights sensitivity analysis where these analyses provide evidence on the vigorous of the outranking results. It is found that these analyses confirm the position of A1 as the most preferred intervention strategy to curtail the COVID-19 transmissions.  The findings would be beneficial for public health authorities to deal with multiple challenges to curb the spread of COVID-19.

IMPACT OF COVID-19 PANDEMIC ON HEALTHCARE ASSOCIATED INFECTIONS: A STUDY FROM A TERTIARY CARE TEACHING INSTITUTE FROM NORTH INDIA

Background: The disease COVID-19 caused by SARS CoV-2 is highly contagious and strict infection control strategies have been adopted to limit the spread of this virus. We studied the impact of COVID-19 prevention and control measures on the rates of other healthcare associated infections (HCAI). Aims and Objectives: Impact of COVID-19 prevention and control measures on the rates of other HCAIs. Study Design: This retrospective study was conducted in the department of microbiology, tertiary care teaching hospital during 2019 and 2020. Material and Methods: Strict Infection prevention and control measures were implemented since 2020 including segregation of patients with respiratory symptoms, mandatory use of mask and strict adherence to standard precautions like hand hygiene. The rates of HCAIs were compared during pre- and post-pandemic periods. Results: Total number of samples were 14,778 and 12,018 in the years 2019 and 2020 respectively. Out of 14,778 samples 271 (1.83%) were found to be positive for HCAI in 2019, while 224 (1.86 %) out of 12,018 samples were found to be positive for HCAI in the year 2020. Conclusion: This study concluded reduction in the rate of SSI during the COVID-19 in the year 2020. Adherence to strict hand hygiene practices was one of the most important factors in preventing SSI.

GAMBARAN PENGETAHUAN DAN PELAKSANAAN HAND HYGINE OLEH TENAGA KESEHATAN PUSKESMAS RUMBAI BUKIT KOTA PEKANBARU TAHUN 2022

Hand hygiene is a general term that applies to both hand hygiene with antiseptic soap and antiseptic handrub. Hand hygiene is one of the effective steps to break the chain of infection transmission, infection prevention and control absolutely must be done by nurses, doctors and all people involved in patient care. The purpose of this study was to determine knowledge about the implementation of hand hygiene by health workers at the Palas Health Center in 2022. This study was a quantitative study with a descriptive design. The population in this study were all health workers who were at the Rumbai bakti Palas Public Health Center in Pekanbaru, which amounted to 30 people. The sample in this study amounted to 30 people. Based on the results of the study that of the 30 respondents at the Rumbai Bukit Health Center, the majority of the knowledge of hand hygiene practice for health workers was good with a total of 29 respondents (96.7%) stating that the knowledge of implementing hand hygiene for health workers was sufficient with 1 respondent (3.3%) ), The results of the study based on the checklist, it was found that of the 30 respondents at the Rumbai Bukit Health Center, Palas the majority of the hand hygiene compliance checklist was good with a total of 30 respondents (100%). Suggestions from this study are expected to provide information to health workers about the implementation of hand hygiene.

HAND HYGIENE COMPLIANCE STATUS OF MEDICAL STAFFS AT THE NATIONAL EYES HOSPITAL, IN 2021

Background: Hand hygiene (VST) is the simplest, most effective and most importantmeasure that contributes to reducing hospital-acquired infections, ensuring the safetyof health workers and improving the quality of patient care.Objectives: Describe the knowledge and practice of hand hygiene of medical staff atthe National Eye Hospital and analyze some related factors.Methods: Cross-sectional survey, quantitative research.Results: This study collected information from 323 health workers (NVYT),National Eye Hospital through questionnaires and observation using checklists. Theresearch results show that the knowledge and practice of hand hygiene in the controlof hospital-acquired infections of health workers is quite good.Conclusion: The rate of health workers with knowledge of hand hygiene reached74.9%. The rate of health workers with practices of hand hygiene reached over 85%.There are 4 factors related to knowledge of hand hygiene including: age, workingposition, working time and professional qualifications. Three factors related topractices of hand hygiene including: Gender, working position and time of trainingon infection control (p<0.05).

Hand hygiene compliance and associated factor among nurses working in public hospitals of Hararghe zones, Oromia region, eastern Ethiopia.

Healthcare workers are in constant contact with a wide variety of materials and surfaces, including waste, body fluids, mucous membranes, food, their own bodies, and the skin of patients. As a result, their hands are colonized by different groups of pathogens. Hand hygiene of healthcare workers is recognized to be the main factor in reducing healthcare-associated infections. Therefore, this study aimed to assess hand hygiene adherence and related factors among nurses working in public hospitals in eastern Ethiopia. An institutional based cross-sectional study was conducted in Hospital, Hararghe zone, Eastern Ethiopia from July 1 to 30, 2021. A total of 451 study participants were randomly selected, after the proportional allocation of study participants to each selected hospital. The data was collected using self-administered questionnaire and observation checklist. SPSS version 26 was used to analyze the data. Bivariable and multivariable analysis were employed to assess the association between outcome and independent variables. Finally, a p-value of < 0.05 was used as a cutoff point for statistical significance. Out of 436 eligible nurses, the overall hand hygiene compliance was 37.4% [95% CI (0.33, 0.42)]. The overall compliance among those working in medical, surgical, OR ward, OPD, Gynecology/obstetrics, emergency ward, Intensive care units, Pediatrics, and other wards/departments was 46.8, 44.8, 35.7, 28.2, 20.7, 45.1, 23.1, 40.5, and 29.4%, respectively. The mean knowledge score was 21.6% (SD: 2.08). Furthermore, there was a statistically significant association between hand hygiene compliance and gender, work experience, training in hand hygiene, availability of running water, and knowledge of hand hygiene. The current study found overall compliance with hand hygiene accounted for 34.7%. Therefore, an exemplary worker may initiate others to do so, and strong managerial and leadership commitment may also help the workers stick to the rules and regulations to follow the multimodal hand hygiene practice as per WHO recommendation.

Decreasing of hand colonization and sterility of refill antiseptic in Dr. Yap Eye Hospital, Yogyakarta

Dr. Yap Eye Hospital, Yogyakarta uses aseptic gel containing 70% ethyl alcohol to refill antiseptic containers during times of antiseptic scarcity. The study aimed to evaluate the effectiveness and sterility of the refill antiseptics in reducing the number of colonization on the hands of nurses. It was a quasi-experimental using pre- and post-control groups design involving 56 nurses who used antiseptics in a bottle sterilized by plasma device (plasma bottle) compare to those washed using detergent (detergent bottle) before being refilled. Sterility tests were performed every two wk for up to two mo. Colonization pre and post hand hygiene practices were determined as an efficacy test and compared using the Mann-Whitney test in STATA 14. Antiseptic in plasma bottles remains sterile until the week8th since refilled, longer than detergent bottles (6th weeks). The pre-handrub colorizations were 0.04-16.92 CFU/cm2 and decreased significantly post-handrub to 0.00-3.08 CFU/cm2 (p&lt;0.0001). Significant decrease pre- vs post-handrub colonization was observed in usage of detergent bottle (0.04-31.04 vs 0.00-10.48 CFU/cm2, p=0.0007). There was no significant difference in ∆ colonization for two bottles (0.40-15.76 vs 0.04-30.92 CFU/cm2, p=0.8790). In conclusion, antiseptic in the plasma bottle remains sterile longer than in the detergent bottle since refilled. Both of them are equally effective in reducing colonization after handrub activity.

Dermatological impact of hand hygiene practices during COVID-19: A cross-sectional web-based survey among doctors in a tertiary care hospital in Eastern India.

The COVID-19 pandemic continues to persist throughout the world with intermittent exacerbation. The changing trend of hand hygiene practices during this pandemic has led to new onset or aggravation of pre-existing hand eczema, especially among doctors. There is a paucity of studies regarding skin changes seen with changing hand hygiene practices in the Indian subcontinent. To estimate the frequency of various cutaneous manifestations and associated factors with hand hygiene practices in doctors during COVID-19 via a web-based online questionnaire survey. It was a cross-sectional web-based survey conducted at a tertiary care teaching institute from July 2021 to September 2021. Those doctors (faculty, residents, and interns) of the hospital completing the questionnaire with electronic informed consent were included in the study. A total of 143 doctors completed the survey. The most common symptoms were dryness in 60 (42%) and itching in 25 (17.5%) doctors. The most common skin changes were scaling in 30 (21%) and redness in 16 (11.2%) doctors. There was a significant association between skin changes and frequency of hand washing and hand sanitizer use (p value < 0.05). The prevalence of hand changes and symptoms was 77% in doctors in our study. The most commonly seen hand changes were scaling followed by redness and symptoms observed were dryness and itching.

Visitor behavior during hospital inpatient visitation.

The common target audience of the current guidelines for the prevention of healthcare-associated infections is represented by healthcare workers. Behavioral protocols for visitors and caregivers that aim to prevent healthcare-associated infections are still not available. The aim of this study was to determine the behavior of the visitors and to determine possible behavior that would contribute to the transmission of pathogenic microorganisms, in order to provide suggestions for visitors in the post-pandemic period. A survey about visitor behavior was administered to 621 visitors. The survey consisted of questions regarding the demographic features and the behavior of the patient visitors. Seventy-seven visitors (12.4%) had at least one infection-related symptoms. Overall, 426 (68.6%) visitors stated that they would cancel their visit if they had any infection-related symptoms. The location of the hand washbasin to wash or sanitize the hands at the patient's unit was not known by 142 (22.9%) visitors. The number of visitors performing all hand hygiene steps was 351 (56.5%). Compliance with hand hygiene was not affected by age, gender, living in the same house as the visited patient, or visiting an adult or pediatric patient. The visitors should be queried about symptoms of infectious disease at the entrance of the hospital. The knowledge level of the visitors about hand hygiene is not sufficient. Clear recommendations about when and how often visitors should practice hand hygiene and providing information at the entrance of the hospital will improve the hand hygiene compliance of the visitors.