Hand Hygiene Resources Research Articles

Impact of hand hygiene interventions on handwashing practices and microbial risk: A study in an orphanage-based school in Pakistan

Orphaned children are often deprived of quality care, making them more susceptible to diseases due to inadequate hand hygiene. The study aimed to assess the prevalence of hand hygiene practices and detect bacterial loads on children's hands before and after hygiene interventions in an orphanage school. The study enrolled all the orphan children registered with the Save Our Souls children's orphanage school in Pakistan. Handwashing practices and swab samples from the hand was collected to evaluate the impact of handhygiene practices on bacterial load. The Quantitative Microbial Risk Assessmentmodel was used to predict the health risk. The study identified the 2 most common bacteria: Staphylococcusaureus and Escherichiacoli. The bacterial contamination was significantly reduced after the intervention (Saureus 166 Colony-forming unit (CFU) /mL and Ecoli 185 CFU/mL). The higher bacterial ingestion rate was attributed to hand contamination and increased bacteria transfer from hand to mouth. The multicomponent hand hygiene intervention showed improvement in accessibility to hand hygiene resources and practices. The findings underscore the need for hygiene interventions in orphanage schools to improve health and educational outcomes.

Longitudinal changes in hand hygiene adherence among healthcare workers during the COVID-19 pandemic, Dominican Republic

Hand hygiene (HH) can reduce transmission of healthcare-associated infections (HAIs) in healthcare facilities and is especially important in low- and middle-income countries where HH infrastructure may be insufficient and the burden of HAIs is highest. At baseline, we assessed HH infrastructure and practices among healthcare workers (HCWs) at two large hospitals in the Dominican Republic during the COVID-19 pandemic. HCWs were observed for HH adherence (HHA) (defined as the use of alcohol-based hand rub (ABHR) or handwashing with soap and water) before and after patient contact and donning new gloves before patient contact. The baseline assessment was repeated following implementation of local production and distribution of ABHR and a HH promotion campaign. Descriptive analyses and regression models evaluated predictors of HHA and glove use. Cumulative HHA was 18.9%. While patient-care areas with a functional HH resource increased from 47% at baseline to 92% after the intervention, HHA declined from 23.0% to 16.7%. HHA was higher after patient contact (aOR = 5.88; 95% CI = 4.17–8.33), during a period of increased COVID-19 risk (aOR = 1.69; 95% CI = 1.05–2.77), during invasive patient contacts (aOR = 1.64; 95% CI = 1.23–2.17) and when gloves were not used (aOR = 1.25; 95% CI = 1.01–1.56). The negative association between glove use and HHA diminished when access to HH resources increased. New gloves were donned before 39.6% of patient contacts. Glove use was higher among nurses (aOR = 7.12; 95% CI = 3.02–16.79) and during invasive contacts (aOR = 4.76; 95% CI = 2.27–10.0). While access to HH resources increased after the interventions, HHA did not increase. HHA was lower when COVID-19 risk was lower. Findings from this study may guide future efforts to increase HHA among HCWs.

Water, Sanitation, and Hygiene Infrastructure and Resources in Schools in Belize during the COVID-19 Pandemic, 2021-2023.

Access to water, sanitation, and hygiene (WASH) resources in schools is critical for disease prevention and control, especially during public health emergencies. In Belize, systematic, national data on WASH in schools are needed to inform public health decisions and interventions. From December 2021 to January 2022, a national survey was sent electronically to government and government-aided primary and secondary schools in Belize (N = 308) to gather information on WASH services. From the survey, 12 pilot schools were selected based on the highest self-reported need for WASH resources to participate in additional evaluation and intervention, which included environmental nudges, supplemental supply provision, and hand hygiene education. To understand how the progression of the COVID-19 pandemic may have influenced hand hygiene, facility assessments to evaluate access to hand hygiene resources were conducted in person when most schools reopened for face-to-face learning during the pandemic (March 2022) and 15 months later (June 2023). Among the schools participating in the national survey (N = 221), 55% reported times when water was not available at the schools. Almost 9 in 10 schools (89%) had a functional handwashing station, and 47% reported always having soap for handwashing. Between baseline and follow-up at the 12 pilot schools, we observed decreases in the proportion of functional handwashing access points (-11%), functional handwashing access points accessible for individuals with disabilities (-17%) and small children (-29%), and functional alcohol-based hand rub dispensers (-13%). Despite the ongoing COVID-19 pandemic, we observed gaps in WASH resources in schools in Belize during the onsite assessments at the pilot schools. Schools should be encouraged and provided with WASH resources to maintain vigilance for disease control measures.

Access to and Use of Hand Hygiene Resources during the COVID-19 Pandemic in Two Districts in Uganda, January-April 2021.

To understand access to and use of hand hygiene in healthcare facilities (HCFs) and community locations during the COVID-19 pandemic, we evaluated factors associated with hand hygiene in 60 priority HCFs and community locations in two border districts in Uganda. We assessed water and hand hygiene resource availability and observed hand hygiene practice by staff or patrons. Regression modeling estimated factors associated with the availability or use of hand hygiene. In HCFs, most inpatient (61%), outpatient (71%), and laboratory or staff (90%) rooms contained hand hygiene materials. Only 38% of community locations had hand hygiene materials at all entrances and exits, 35% of congregation areas had hand hygiene materials. Overall, 38% of healthcare staff, 48% of patrons post-latrine use, and 21% of patrons entering or exiting community locations practiced hand hygiene. HCF hand hygiene access was lower in inpatient rooms (odds ratio [OR] = 0.17, 95% CI: 0.06-0.45) and outpatient rooms (OR = 0.23, 95% CI: 0.07-0.70) compared with laboratory/staff rooms. HCF hand hygiene practice was higher for doctors than nurses (OR = 3.58, 95% CI: 1.15-11.14) and with new versus existing patient encounters (OR = 2.27, 95% CI: 1.20-4.27); it was lower before versus after patient contact for both invasive (OR = 0.03, 95% CI: 0.00-0.20) and noninvasive (OR = 0.66, 95% CI: 0.45-0.95) procedures. In community settings, hand hygiene practice after using the latrine was higher than at an entrances/exits (OR = 3.39, 95% CI: 2.08-5.52). Hand hygiene rates were relatively low in healthcare and community settings. Greater emphasis on hand hygiene before patient interactions (at HCFs) and at community entrances/exits for patrons is also needed.

An Assessment of Hand Hygiene Practices among Health Care Providers in Operation Theatre

Aims: To assess the frequency of hand hygiene opportunities available to health care providers during surgeries and to assess the frequency of hand hygiene practices of health care providers in those hand hygiene opportunities. Study design: Cross sectional study Place and duration of study: Operation theatre and recovery room at The Indus Hospital Korangi Campus and Sheikh Saeed Memorial Campus from 21stMarch 2021 to 30th August 2021 Methodology: Two hundred and eighty one health care professional for 55 surgeries were included for hand hygiene opportunities and their hand hygiene practice. Every opportunity to practice hand hygiene was observed and noted as having occurred (hand wash or hand rub) or missed. Throughout the period, the PI was recorded opportunities for hand hygiene and missed opportunities using WHO’s hand hygiene observational form. Results: The average age of the health care provider was 31.22±8.15 years. The overall adherence to hand hygiene practice according to WHO guidelines was 16.1% while 83.9% were not according to WHO hand hygiene guideline. Failure of hand hygiene practice was significantly high in all type of hand hygiene opportunity. Rate of missed/failure hand hygiene practice was significantly high in nurses and technician and also their qualification (p<0.05). Conclusion: The poor hand hygiene compliance was frequently noticed among health care workers. Hand hygiene should be an educational priority and it needs to be implemented effectively. Therefore, hand hygiene resources is an integral part for better strategic and improvement strategy. Keywords: Hand hygiene, Contamination, Health care associated infections; Prevention.

A STUDY OF KNOWLEDGE, ATTITUDE AND PRACTICES RELATED TO HAND HYGIENE AMONG FIRST YEAR STUDENTS OF NURSING AND PHARMACEUTICAL COLLEGE IN CENTRAL INDIA: COMPARATIVE CROSS SECTIONAL STUDY

Aim: To assess the knowledge, attitude and practices related to hand hygiene among first year undergraduates of Nursing and Pharmacy in Durg district. Design: Comparative cross sectional study. Methods: Study was conducted among two groups of undergraduate students belonging to the first year of their respective course. The first group included 118 students pursuing first year of Bachelors in Pharmacy course at a private institute of pharmaceutical science and research and the other group included 181 students pursuing first year of Bachelors of Science, Nursing course at a private nursing institute located in Durg District. All study subjects were surveyed with a questionnaire regarding their Knowledge, attitude and practices related to hand hygiene. Statistical Analysis: Shapiro Wilk test, Z- test, Mann Whitney U test. Results: A questionnaire based responses was obtained from 299 first year undergraduate students of nursing and pharmacy. Nursing students had better knowledge (P<0.000), attitude (P=0.013) and practice (P<0.000) than the pharmacy students. Conclusion: Our study emphasizes the need for educational and training programs about hand hygiene and its techniques, risks related to improper hand hygiene. There is also a need to augment the availability and accessibility of hand hygiene resources. Adequate knowledge and training regarding hand hygiene may help bring about a change in attitude towards hand hygiene, better compliance, reducing the transmission of infections and, ultimately, building a healthy society.

A WHO Guided Journey of Hand Hygiene (HH) from Basic to Advance Level in Lower Middle-Income Country (LMIC)

<h3>Background</h3> According to WHO; Hand hygiene is a primary measure to reduce hospital acquired infections. It is a simple act but the lack of compliances among health care workers. World Health Organization (WHO) offers a Hand hygiene Self-assessment framework to identify area of improvements and develop action plan and strategies accordingly. Being a low/middle income country initial scoring came to be 195 points i.e., Basic level thus we aim to achieve advance level i. e. > 375. <h3>Methods</h3> To work on project, Plan, Do, Study, Act (PDSA) quality improvement cycle was initiated, process and outcome indicators were measured to analyze the cause and effects/fish bone diagram was used. WHO's hand hygiene self-assessment framework/tool was utilized which has five components system change, training/ education, evaluation/ feedback, reminders in workplace & institution's safety climate for Hand Hygiene. Reassessments were done periodically to document the progress over time in each component and overall to track their progress in hand hygiene resources, promotion activities, plan their actions. <h3>Results</h3> After implementation of multiple strategies in each section of WHO's self-assessment framework we were able to achieve our set goal and our overall score increased from basic i.e., 195 to advance i.e., 395. In addition to that our category wise score also increased i.e., in system change from 60 to 85, in training/ education from 35 to 100, in evaluation/ feedback from 52.5 to 100, reminders in workplace from 17.5 to 45 & Institution's Safety Climate from 30 to 65. <h3>Conclusions</h3> WHO's hand hygiene self-assessment framework should be utilized by all the hospitals in lower- and middle-income country as a guide to improve their hand hygiene levels. It provides an opportunity to reflect on existing resources and helps to focus on future and challenges. It acts as a diagnostic tool, identifying key issues requiring attention and improvement.

How Well Are Hand Hygiene Practices and Promotion Implemented in Sierra Leone? A Cross-Sectional Study in 13 Public Hospitals.

Healthcare-associated infections (HAIs) result in millions of avoidable deaths or prolonged lengths of stay in hospitals and cause huge economic loss to health systems and communities. Primarily, HAIs spread through the hands of healthcare workers, so improving hand hygiene can reduce their spread. We evaluated hand hygiene practices and promotion across 13 public health hospitals (six secondary and seven tertiary hospitals) in the Western Area of Sierra Leone in a cross-sectional study using the WHO hand hygiene self-Assessment framework in May 2021. The mean score for all hospitals was 273 ± 46, indicating an intermediate level of hand hygiene. Nine hospitals achieved an intermediate level and four a basic level. More secondary hospitals 5 (83%) were at the intermediate level, compared to tertiary hospitals 4 (57%). Tertiary hospitals were poorly rated in the reminders in workplace and institutional safety climate domains but excelled in training and education. Lack of budgets to support hand hygiene implementation is a priority gap underlying this poor performance. These gaps hinder hand hygiene practice and promotion, contributing to the continued spread of HAIs. Enhancing the distribution of hand hygiene resources and encouraging an embedded culture of hand hygiene practice in hospitals will reduce HAIs.

An observational study of hand hygiene compliance of surgical healthcare workers in a Nigerian teaching hospital.

Patients sometimes contract healthcare associated infections (HCAI) which are unrelated to their primary reasons for hospital admission. Surgical site infections are the most investigated and most recurrent type of HCAI in developing countries, affecting up to one-third of surgical patients. This study aimed to assess and offer context to the hand hygiene resources available in a Nigerian teaching hospital through ward infrastructure survey, and to determine the hand hygiene compliance rate among surgical healthcare workers (HCWs) in a Nigerian teaching hospital through hand hygiene observations. Ward infrastructure survey was conducted in the two adult surgical wards of the hospital using the World Health Organisation (WHO) hand hygiene ward infrastructure survey form. Hand hygiene observations were monitored over seven days in the surgical wards using a modified WHO hand hygiene observation form. Hand hygiene resources were insufficient, below the WHO recommended minimum standards. Seven hundred hand hygiene opportunities were captured. Using SPSS version 24.0, we conducted a descriptive analysis of audit results, and results were presented according to professional group, seniority and hand hygiene opportunities of the participants. Overall hand hygiene compliance was 29.1% and compliance was less than 40% across the three professional groups of doctors, nurses and healthcare assistants. Hand hygiene compliance rates of the surgical HCWs are comparable to those in other Sub-Saharan African countries as well as in developed countries.

Role of cleaners in establishing and maintaining essential environmental conditions in healthcare facilities in Malawi

Abstract Healthcare facility (HCF) cleaners play an important role in preventing healthcare-acquired infections and promoting a safe and clean healthcare environment. There is little evidence describing cleaner roles in HCFs in low-income countries and factors facilitating and constraining their roles and responsibilities. We analyzed qualitative and quantitative data from 57 in-depth interviews with cleaners in 44 government-run HCFs in Malawi. Cleaner constraints included inadequate training on infection prevention and control (IPC), personal protective equipment (PPE), hand hygiene, and waste management; insufficient PPE and hand hygiene resources; assignment of tasks that are unrelated to core responsibilities and their job description; risk of work-related injuries; and disrespect and stigma from medical staff, patients, and guardians. Facilitators included the positive collaboration and communication with medical staff, high job satisfaction, and a positive working attitude. We recommend the provision of more robust IPC, PPE, hand hygiene, and waste management training (including orientation and refresher). PPE resources must be made available to ensure HCF cleanliness and to keep cleaners, staff, patients, and guardians safe. Clearly defined job descriptions for cleaners will clarify their roles, describe bounds of their work, and ensure cleaners are viewed as essential frontline workers who ensure the safety of staff and patients.

What are healthcare workers’ preferences for hand hygiene interventions? A discrete choice experiment

ObjectivesTo understand the key attributes in designing effective interventions for improving healthcare workers’ (HCWs’) hand hygiene compliance and HCWs’ preference for these attributes.DesignA discrete choice experiment (DCE) was conducted with...

Correlation of Hand Hygiene Knowledge and Hand Decontamination Practices of Medical Students

Objectives: To determine the knowledge of MBBS students of a public sector medical university regarding hand hygiene and to assess the practical implication of their knowledge regarding hand hygiene during the clinical postings. Study Design and Setting: A cross sectional study was conducted in Sindh Medical College, Jinnah Sindh Medical University (SMC-JSMU) Karachi, from July to November 2018. Methodology: A total of 316 M.B.B.S students from first year to final year were included in the study. Students were equally divided into preclinical and clinical groups. Hence, the knowledge of preclinical and clinical students were compared in the present study. Age range of participants was 18 to 24 years and both male and female participants were involved. Data was analyzed by SPSS 22.0. P value &lt; 0.05 was considered as statistically significant. Results: Approximately 249 (78.8%) students agreed that hands of health care workers are a source of nosocomial infections. Nearly 293 (92.7%) students admitted that hand decontamination and gloving is necessary before bedside procedures. Only 61 (38.6%) students performed it routinely. Chief restricting factor in performance of hand hygiene was inadequate supply of hand hygiene resources as reported by 122 (77.2%) students. Conclusions: Majority of medical students in both preclinical and clinical groups were well aware of HH practices and its significant role in infection control. However, only a limited number of students routinely performed HH. The difference between knowledge and practice of students was mainly due to the inadequate facilities of hand washing in public sector hospitals

A Journey of Hand Hygiene (HH) from Basic to Advance Level at a Tertiary-Care Hospital in Karachi, Pakistan

Background: According to the WHO, hand hygiene is the primary measure to reduce infections. It is a simple act, but the lack of compliance among healthcare workers has been a great concern for all healthcare facilities. Healthcare facilities can perform a situation analysis of hand hygiene promotion and practices according to a set of indicators designed by the WHO in the form of a hand hygiene self-assessment framework. Results can be used to identify areas of improvement and to develop an action plan and strategies accordingly. Low- or middle-income country (LMIC) initial scoring within this framework was 195 points (ie basic level); thus, we aimed to achieve the advanced level, with a score of &gt; 375. Methods: The WHO hand hygiene self-assessment framework is a diagnostic tool to identify key issues requiring attention and improvement. Repeated assessments are done to document the progress over time, which allows a health-care facility to track their progress in hand hygiene resources, to conduct promotion activities, to plan their actions, and to achieve improvement and sustainability. We developed an action plan under each category of WHO framework that included: system change, training and education, evaluation and feedback, reminders in workplace, and institutional safety climate for hand hygiene. We implemented the following measures: point-of-care hand hygiene stations were made available at all bedsides; mandatory training was introduced for all healthcare workers, and consumption of hand rub or hand sanitizers and liquid soap was monitored as a consumption indicator. In addition, posters were placed in all wards and clinics, time was dedicated for HH promotion, and a May 5th plan was implemented. HH leaders, role models, and champions were identified from each discipline. Patients were involved in HH promotion; HH leaflets were given to patients, HH e-learning tools were implemented, and a system for personal accountability was initiated, as well as a buddy system for new employees. Results: After implementation of multiple strategies in each section of the WHO self-assessment framework, we our overall score increased from basic (ie, 195) to advanced (ie, 395). In addition, category score increased in system change from 60 to 85, in training and education from 35 to 100, in evaluation and feedback from 52.5 to 100, in reminders in workplace from 17.5 to 45, and in institutional safety climate from 30 to 65. Conclusions: The WHO hand hygiene self-assessment framework should be utilized by all the hospitals in LMICs as a guide to improve hand hygiene levels.Funding: NoneDisclosures: None

Correlates of access to hand hygiene resources in Ghanaian households: An exploratory analysis of the 2014 demographic and health survey

ObjectivesHandwashing with soap and water remains the most effective public health measure to reduce the risk of infectious diseases, which kill over 2.5 million people annually, mostly children in developing countries. The absence of hand hygiene resources in homes put many at risk of these infectious diseases. In the wake of the outbreak of the COVID-19 pandemic, the World Health Organization (WHO) and governments around the world have stressed the importance of regular handwashing to prevent the spread of the virus. This suggests that research on water, sanitation, and hygiene issues deserve continuous scholarly attention. In Ghana, studies on household's access to hand hygiene resources are few and relatively old. Therefore, this study estimated the proportion of Ghanaian households with access to hand hygiene resources and their associated determinants using data from a recent national survey. MethodsThe study used the cross-sectional 2014 Ghana Demographic and Health Surveys dataset. We used STATA-14 to perform data analyses on a weighted sample of 11,710.06 households. We used complex samples analysis technique to adjust for sample units, stratification and sample weights for both the descriptive statistics and multivariate robust Poisson regression. ResultsThe result showed that about one fifth of Ghanaian households had access to hand hygiene resources. Households with heads who attained a Middle/JHS/JSS or Secondary/SSS/SHS/Higher level education, those headed by persons having at least 30–44 years, and non-poorest households, and from the Volta region were more likely to have access to hand hygiene resources. Further, households in urban areas, households that spent between 0-30 min to get to a source of water, and households in Eastern and Brong-Ahafo regions were less likely to have access to hand hygiene resources. ConclusionThis study identified key socioeconomic and demographic correlates of a household's access to hand hygiene resources in Ghana. In the interim, the government and development partners can provide hand hygiene resources to households with limited or no access. For the long term, we recommend that the government should implement measures and policies that facilitate citizens' economic independence and their attainment of higher formal education.

Effect of using portable alcohol-based handrub on nurses’ hand hygiene compliance and nasal carriage of staphylococcus aureus in a low-income health setting

Low hand-hygiene compliance (HHC) in low-income countries due to deficient hand hygiene resources may increase nasal carriage of S. aureus, a causative agent of health care-associated infections. The study aimed to assess the effect of using locally available portable alcohol-based handrub (ABHR) regarding nurses' HHC and nasal carriage of S. aureus. Nonrandomized interventional design. Seventy-two (72) of 86 nurses were provided with portable ABHR to use during patient care (intervention group). The remaining 14 nurses constituted the control group. Evaluation was done via HHC observation per WHO 5-moments of HH, determining S. aureus nasal carriage prevalence and HH guideline knowledge assessment via a self-response questionnaire. In the intervention group, HHC improved from 48.9% to 67.7% (P < .001) especially for hand-hygiene before and after patient contact. Hand-hygiene by handrubbing improved from 16 to 105 moments. There was positive feedback to portable ABHR use from nurses. S. aureus nasal carriage significantly decreased from 30.6% to 21% (P < .031). Negative carriage of S. aureus was significantly associated with increase in HHC (P < .001). Despite the low preintervention HHC, nurses showed considerably high levels of knowledge on relevance of hand hygiene. Portable ABHR use was associated with improved HHC and reduced S. aureus nasal carriage prevalence. As nurses' knowledge of HH guidelines was high, provision of portable ABHR compensated for deficient facility HH resources resulting in improved HHC, which effected reduction in nasal carriage of S. aureus among nurses.

Factors influencing hand hygiene practice of nursing students: A descriptive, mixed-methods study

Developing nursing students' knowledge and practice of infection prevention and control (IPC) is fundamental to safe healthcare. A two-phase descriptive, mixed-method study conducted within a Bachelor of Nursing program at an Australian university aimed to explore: (i) theoretical knowledge of IPC, highlighting hand hygiene, of nursing students and; (ii) nursing students' and clinical facilitators' perceptions of factors influencing these practices during clinical placement. Phase One utilised an anonymous validated questionnaire assessing students' knowledge; identifying variables influencing students' IPC practices, subjected to descriptive and inferential analysis. Phase Two were semi-structured interviews exploring clinical facilitators' experiences/perceptions of students during clinical placement, analysed thematically. Students' demonstrated satisfactory knowledge of IPC in their second and third year, but clinical facilitators perceived that. students lacked awareness of the importance of these practices. Five themes arose from the interviews: (i) understanding workplace culture; (ii) students' modelling local behaviour; (iii) enhancing and consolidating knowledge for practice; (iv) adjusting to practice reality and; (v) accessing additional hand hygiene resources. Factors specific to workplace setting and culture were perceived to influence nursing students' socialisation. Future practice/education strategies could address these factors by ensuring students receive adequate supervision during clinical placement, and having strong advocates/role models present in the workplace.

Understanding Hand Hygiene in Healthcare Environments – A Management’s Perspective

The current policies and strategies on hand hygiene, and the current management view on the influence of facility design, operations, and management on hand hygiene were documented through a series of interviews with personnel in key management positions. The study proposes for the need for better planning and management of hand hygiene resources by encouraging interdisciplinary dialogues between various groups of healthcare providers to mitigate potential infectious disease control issues and facility operational challenges.

Nurses’ perceptions of reasons for persistent low rates in hand hygiene compliance

AimThe purpose of this study was to explore nurses’ perceptions of reasons for persistent low rates in hand hygiene compliance in the Critical Care Unit and their recommendations for improvement. Design and methodsThis study used an exploratory, descriptive survey design to identify critical care nurses’ perceptions of barriers to hand hygiene compliance in the unit and their recommendations for improvement. ResultsNurses selected high workload, understaffing and suggested lack of time as the main problems with hand hygiene compliance in the critical care unit. Second to that, they identified difficulty accessing sinks and lack of appropriately located hand sanitisers at the point of care complemented by suggestions of not enough sinks and inconveniently located hand sanitiser as major barriers to hand hygiene compliance. ConclusionResults of this study indicate that high workload and understaffing added to difficulty accessing hand hygiene resources contribute to low rates of hand hygiene compliance in the critical care unit. Addressing nursing understaffing and workload and making some environmental modifications to allow easy access to sinks and hand sanitisers may facilitate nurses hand hygiene compliance in this setting. Further studies on the relationship between nurses’ workload, unit staffing, and hand hygiene compliance rates are needed.

Hand hygiene: Knowledge and practice by health care workers in a tertiary health care facility in South East Nigeria

BACKGROUND: The prevalence of health care associated infections can be reduced by hand hygiene (HH). This study is aimed at determining the knowledge and practice of HH among healthcare workers (HCWs). METHOD: descriptive cross-sectional study using semi-structured questionnaire among HCWs selected by cluster sampling was carried out at University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu. RESULTS: Respondents were 629, mostly females (64.4%), married (62.3% and aged between 19 and 59 years. About 63% received training on HH. Average knowledge score was 80.3%. All respondents knew about the following moments of HH: before exiting patient’s care area and after contact with body fluids. However, 45.6% and 54.2% knew that HH was indicated before touching a patient and after removing hand gloves respectively. Only 12.2% of respondents washed hands before patients. All doctors and nurses washed hands before aseptic procedures. Regular access to HH resources were 17.6%, 7%, 5.5%, and 1.7% among medical laboratory scientists (MLS), doctors, nurses, and health attendants respectively. CONCLUSION: knowledge of HH was generally high but practice was poor for some moments of HH like before wearing gloves and leaving patients’ care area. Unavailability of HH resources was implicated. Keywords: Hand hygiene, knowledge, practice, healthcare workers Running Title: Healthcare workers and hand hygiene

Current status of personnel and infrastructure resources for infection prevention and control programs in the Republic of Korea: A national survey.

There is significant variability in personnel and infrastructural resources for infection prevention and control (IPC) among health care institutions. The aim of this study is to evaluate the current status of individual hospital-based IPC programs in the Republic of Korea (ROK). A multicenter cross-sectional survey of 100 hospitals participating in the national surveillance programs for multidrug-resistant organisms (MDROs) in the ROK was conducted in September 2015. The survey consisted of 140 standardized Web-based questionnaires. The survey response rate was 41.0%. The responding hospitals are largely organized with multibed rooms, with an insufficient numbers of single rooms. Employment status of infection specialists and hand hygiene resources were better in larger hospitals. The responding hospitals had 1 full-time infection control nurse per 400.3 ± 154.1 beds, with wide variations in training and experience. Facilities have great diversity in their approach to preventing MDROs. There appeared to be no difference in supplies consumption and protocols for IPC among the hospitals, stratified according to size. A greater availability of specialist personnel, single rooms, and a comprehensive IPC program, with the support of a policy-oriented management, is necessary to achieve effective IPC.