Hand Rub Research Articles

Making the invisible visible: Effectiveness of a training program to increase awareness and biosecurity compliance in poultry barn anterooms, using glowing substances

Biosecurity is the cornerstone of prevention strategies to limit infectious pathogen spread between poultry farms. However, poor compliance of biosecurity measures is often observed when entering or exiting barns. The lack of knowledge, understanding, risk perception or technical skill are often described for anteroom-related biosecurity errors (i.e., not respecting anteroom zoning in relation to changing boots, clothing, and hand sanitation). In this study, we designed and assessed the efficacy of an intervention aiming at improving biosecurity compliance in anterooms, using substances glowing under ultraviolet light, which mimic microbiological contamination. Training exercises offered in a single session were proposed to 145 participants with an interest in animal farming (veterinary students, agricultural students, poultry farmers and poultry farm advisors). The exercises’ efficacy was assessed by measuring the change in attitude and intentions of participants about specific biosecurity measures. The participants’ attitudes and intentions were quantified using a questionnaire before and after training. The change in score was assessed in a multivariate linear regression model to measure the effect of various parameters on this change. The attitudes and intentions of participants were statistically improved (p < 0.05) and were affected by the initial attitude and intention score, the gender of the participants and the status of the participant (type of student or activity in the poultry industry). The use of this exercise material, perceived as playful and engaging, could be included in the framework of biosecurity training for all stakeholders of the poultry industry.

Physical therapists’ use of personal protective equipment during the COVID-19 pandemic: a cross-sectional study in Saudi Arabia

Background: Physical therapy (PT) services can be essential for recovery from coronavirus disease 2019 (COVID-19) infection. Maintaining an efficient healthcare service is achieved by ensuring the safety of a well-informed healthcare practitioner. This study aimed to assess the sources of knowledge, attitude, experience, and accessibility to the personal protective equipment (PPE) of the physical therapists working in Saudi Arabia. Methods: A cross-sectional study was conducted to survey on-duty PT practitioners using a web-based questionnaire. Licensed PT practitioners were invited to participate, and a sample of 424 therapists responded. The questionnaire comprised of 22 questions covering the demographic data and the following domains: sources of knowledge regarding the pandemic, experience, and attitude of the therapists during the pandemic, and accessibility to the PPE. Results: Around 83% of the participants (352) completed all the survey questions. Governmental websites were the most used source of knowledge (39%). Hand sanitization was implemented by the majority of participants (81%). Participants, mainly males and experienced therapist, were willing to treat COVID-19 patients. The COVID-19 complications of prolonged ventilation and immobilization were successfully treated by 91.2% of participants who treated positive cases. About a third of the participants were part of COVID-19 management planning teams or received training to deal with the pandemic. Most of the necessary PPE was adequately accessible during the pandemic. Conclusions: Therapists implemented the recommended hygienic practices and had no problems accessing the necessary PPE. More efforts should target therapists’ education about the social media misleading information and involving the therapists in the pandemic management planning teams.

Study on hand disinfection in inpatient geriatric care on the superiority of cold plasma aerosol versus alcohol-based disinfection methods in a parallel group design

The introduction of fundamental hygiene protocols within the healthcare sector during the nineteenth century led to a significant reduction in mortality rates. Contemporary advancements, such as alcohol-based sanitizers, have further enhanced hand hygiene practices. However, these measures are often overlooked in nursing facilities, resulting in low staff compliance rates and increased cross-infection rates. Novel approaches, such as cold plasma hand disinfection, present promising alternatives due to their minimal skin damage and economic benefits. This study aims to compare the disinfectant efficacy of cold plasma aerosol under practical application conditions with an alcoholic hand disinfectant listed by the Association for Applied Hygiene. The microbial count on participants’ hands was measured, with particular attention paid to the spontaneous occurrence of fecal indicators and the presence of potentially infectious bacteria. A t-test for independent samples was conducted to determine whether there was a significant difference between the two cohorts regarding the research question. Statistical analysis revealed that the mean log colony-forming unit (CFU) values were significantly lower in the test cohort using only the cold plasma method for hand disinfection compared to the cohort using conventional alcohol-based hand disinfection. Moreover, it was demonstrated that, unlike alcohol-based hand disinfection, cold plasma application ensures the effective elimination of Staphylococcus aureus. The findings indicate that staff utilizing plasma disinfection have an average bacterial count that is 0.65 log units lower than those who regularly use alcohol-based hand disinfection. In addition to the efficacy of cold plasma disinfection, its superiority over alcohol-based hand disinfection was also established. Beyond offering economic and logistical advantages, cold plasma disinfection provides additional health benefits as it does not induce skin damage, unlike alcohol-based hand disinfection.

Clinical Effectiveness of a 3-Step Versus a 6-Step Hand Hygiene Technique: A Randomized Controlled Cross-over Study

Abstract Background The aim of this study is to assess the clinical effectiveness of the 3-step hand hygiene (HH) technique (3-HT) compared with the 6-step HH technique (6-HT; World Health Organization 6-step technique) using an alcohol-based hand rub. Methods A randomized controlled crossover trial was conducted from November to December 2023 in 10 wards of a tertiary A-level hospital according to CONSORT guidelines. The 240 healthcare workers (HCWs) were randomly divided into the 3-HT intervention group or the 6-HT control group. The trial was conducted in 2 stages, and the effectiveness of each indicator in the 2 groups was compared after a washout period of 2 weeks. Results Compared with the 6-HT, the 3-HT has demonstrated significant superiority in all indicators of HH compliance as well as the accuracy rate of HH practices. The total HH median times for the 3-HT and 6-HT were 16.00 (interquartile range, 15.00–20.00) and 32.50 (30.00–40.00) seconds, respectively (P &amp;lt; .05). The reduction factors for bacterial colony-forming unit counts did not differ and the colony-forming unit counts were not significantly different. Bacillus, Staphylococcus, and Micrococcus were detected before and after the use of hand rubs. HCWs preferred the 3-HT over the 6-HT. There were no significant difference in healthcare-associated infections rate between the 2 techniques. Conclusions The 3-HT was significantly superior to the 6-HT in terms of the HH eligibility rate, compliance, and HH time. The safety and feasibility of the 3-HT were verified by assessing microorganism count.

Clean hands are caring hands: Improving anesthesia provider hand hygiene and double-glove compliance during induction of general anesthesia

Hand hygiene and double gloving practices during induction of general anesthesia can decrease transmission of bacteria to patients and subsequent healthcare associated infections; however, compliance to these practices is low. A pre/post-implementation quality improvement design was used with Plan-Do-Study-Act cycles. Several implementation strategies were used to improve hand hygiene and double glove compliance among anesthesia providers, including printed educational materials, video, in-person, and virtual meetings, visual reminders, audit and feedback, and improved access to hand sanitizer dispensers in the anesthesia workstation. Average hand hygiene compliance increased from 0% to 11.8% and double gloving compliance increased from 18.5% to 34.5%. A decrease in surgical site infections was shown in the post-implementation period. Although hand hygiene and double gloving practices increased after the initial implementation, the improvements were not sustained long-term. Practices to support sustainability, such as routine booster sessions, may be considered. Incorporating these quality improvement measures into practice may improve anesthesia provider hand hygiene compliance during induction of general anesthesia and impact subsequent infection rates.

Geothermal Flora and AgNPs Synergy: A Study on the Efficacy of Lantana camara and Acrostichum aureum-Infused Hand Sanitizers

Hand hygiene is an important factor that needs to be observed in controlling the spread of diseases transmitted through hand-to-hand contact. Synthesis of silver nanoparticles from tembelekan (Lantana camara) and paku laut (Acrostichum aureum) using the green synthesis method has good antibacterial activity against Staphylococcus aureus and Escherichia coli bacteria. Therefore, a preparation formulation was made, namely hand sanitizer, which is still rarely used. Formulations that have successfully entered the evaluation stage include organoleptic tests, homogeneity tests, spreadability tests, adhesion tests, viscosity tests, pH tests, accelerated stability tests, and irritation tests. Antibacterial activity was evaluated against bacteria Staphylococcus aureus and Escherichia coli. The hand sanitizer is formulated to contain 5% tembelekan AgNPs (F1); paku laut AgNPs 5% (F2); and a combination of 2.5% paku laut AgNPs and 2.5% tembelekan AgNPs. The resulting hand sanitizer has good organoleptic characteristics, except for the color of the preparation, which changed during the accelerated stability test. Test results for pH, adhesion, spreadability, viscosity, and homogeneity of hand sanitizer meet the requirements of a good test. Irritation tests on ten volunteers showed no irritation reaction. Antibacterial tests show that hand sanitizer has bacterial antibacterial activity with an average ± standard deviation of the inhibition zone Staphylococcus aureus is 6.605±0.459(F1); 6.665±0.615(F2); 6.380±0.282(F3) dan Escherichia coli namely 6.575 ± 0.219 (F1); 6.860 ± 0.155 (F2); 6.810 ± 0.056 (F3). Making hand sanitizer AgNPs-based ingredients from plants can be used as hand sanitizer, but stabilizers are required to prevent color changes during storage.

Changes in Access to Alcohol-Based Hand Rub and Hand Hygiene Adherence among Healthcare Workers after a Hand Rub Production and Distribution Program in Rural Uganda before and during the COVID-19 Pandemic.

During the COVID-19 pandemic, the use of alcohol-based hand rubs (ABHRs) was critical for improving hand hygiene (HH) among healthcare workers (HCWs). Before and during the pandemic, we supported district-led production and district-wide distribution of ABHRs and one-time provision of portable handwashing stations to select healthcare facilities (HCFs) in five rural districts in Uganda. Comparison between baseline and follow-up assessments showed an overall increase in access to HH materials and HH adherence (HHA; handwashing with soap and water or use of ABHR) among HCWs. However, large differences in the changes in HH material coverage and HHA across districts may have been heavily influenced by the COVID-19 disease burden and its risk perception when the assessments were conducted. Using data collected at multiple time points before and during the pandemic across districts and estimating and controlling for pandemic effects in an exploratory multivariate analysis, the adjusted odds ratio of HHA in district HCFs was 4.6 (95% CI: 1.8-11.8) after (versus before) the ABHR intervention. This increase appeared to be primarily in larger HCFs, where the perceived need for ABHRs may have been greater. Additional strategies are needed to further increase HHA, especially in the smallest HCFs, among laboratory technicians and nurses and before patient contact. However, district-scale ABHR interventions seemed successful in ensuring the continued availability of HH materials.

Antiviral Effects of Ozonated Water for Handwashing Against SARS-CoV-2 Omicron Variant Using the E1052-20 Test Method of the American Society of Testing Materials International

ABSTRACT Alcohol-based hand rubs are generally recommended for infection control of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hand hygiene agents, including ozonated water (OW), have been used as an alternative because alcohol-based products may cause skin damage. A few reports are available on the virucidal activity of OW against SARS-CoV-2; therefore, this study examined the inhibitory effect of 0.4, 1.0, and 4.0 ppm OW on the Omicron variant infection to VeroE6 cells expressing transmembrane protease serine 2 by calculating the median tissue culture infectious dose (TCID50) using the E1052–20 test method of the American Society of Testing Materials International. Additionally, viral RNA copies were measured in culture supernatants of control or OW. Each OW concentration demonstrated ≥5.6 log10 TCID50 reduction, corresponding to ≥99.999% reduction of infectious virus, while the control phosphate-buffered saline showed no inactivation effect. More than 5 log10 copies/mL reduction of viral RNA was observed in the culture supernatant of each OW compared with the control. These findings suggest that exposure of SARS-CoV-2 to at least 0.4 ppm OW for 5 s is sufficient for viral inactivation and that OW can be used as an alternative hand hygiene agent to prevent SARS-CoV-2 infection.

Formulation of Tembelekan Leaf Hand Sanitizer (Lantana camara L.) and Antibacterial Activity Test Against Escherichia coli and Staphylococcus aureus

Disease-causing microorganisms stick to hands every day through physical contact with the environment. One of the easiest and most appropriate ways to clean them is to wash hands with soap and clean water. This study aims to determine the formulation of tembelekan leaf hand sanitizer (Lantana camara L.) and test its antibacterial activity against Escherichia coli and Staphylococcus aureus. Assessment of the arrangements acquired incorporates organoleptic tests with libertine tests, homogeneity, pH, spreadability, dependability, bothering to chip in skin, and antibacterial movement against Staphylococcus aureus and Escherichia coli by agar dispersion utilizing poke holes. The outcomes showed that the hand sanitizer readiness containing 10% tembelekan leaf remove was the best planning since it was liked by specialists, stable when put away at room temperature for a very long time, didn't cause bothering, and had solid antibacterial movement so that the tembelekan leaf gel planning utilized as a characteristic natural substance can be utilized to clean hands from microscopic organisms that is simple, reasonable and protected to use without utilizing water.

COVID-19-Related Risk Factors for Developing Occupational Contact Dermatitis Along With Its Incidence, Prevention, and Management: A Systematic Review.

Occupational contact dermatitis (OCD) is an eczematous local inflammatory skin irritation caused by repeated use of hand sanitizer and other chemical substances. Occupational irritant contact dermatitis (OICD) and occupational allergic contact dermatitis (OACD) are the two variants of CD that cannot be identified clinically. Hand dermatitis (HD) is typically assessed as a clinical consequence because it affects the hands most frequently at work as per epidemiological studies on OCD. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 standards were followed when conducting this umbrella review. We used the search terms "Occupational Contact Dermatitis AND COVID-19" to search forthe most pertinent papers in full text on the databasesPubMed/MedLine, ScienceDirect, and PubMed Central (PMC). Additionally, the reference section of the papers was used to find more articles. A total of 11,646results were found, and eight papers remained after applying the inclusion criteria (full-text papers, English language, studies published in the previous 10 years, involving humans, and only systematic reviews). After completing the title and abstract screening, we obtained five papers. Next, the full-text screening and AMSTAR quality check were completed, yielding the same five papers. After searching ScienceDirect, five papers that met the inclusion criteria were included, and six papers were selected from the references, yielding a total of 11 papers. The causes of occupational dermatitis from protective face masks are discussed in this review. We anticipate an increase in the incidence of occupational dermatitis linked to face mask use given that a large segment of healthcare workers (HCWs) wear protective face masks. To understand the prevalence and available therapies for mask-related occupational dermatitis, further well-designed research is required.

Impact of Direct Observation on Hand Hygiene Compliance in a Dental University Hospital: A Retrospective Cohort Study.

Introduction Hand hygiene is crucial for preventing healthcare-associated infections in dental settings. Despite its importance, the hand hygiene compliance rates remain unclear, particularly in dental university hospitals where teaching, research, and clinical practice intersect. This study aimed to establish a baseline of hand hygiene compliance rates in a dental university hospital, evaluate the effectiveness of direct observation in improving compliance, and compare practices among different categories of healthcare workers. Materials and methods This retrospective cohort study was conducted at Kanagawa Dental University Hospital from April 2022 to March 2023. The design included four blinded direct observations to establish baseline compliance rates, followed by educational training and four unannounced explicit observations. Compliance was assessed based on the World Health Organization's "Your 5 Moments for Hand Hygiene: Dental Care," adapted for dental outpatient services. The study focused on hand hygiene using alcohol-based hand sanitizers, and compliance rates were calculated for dentists, dental hygienists, dental assistants, and trainee dentists. Monthly consumption of hand sanitizer per patient was tracked from January 2019 as a secondary measure. Statistical analysis included Fisher's exact test, unpaired t-tests, and analysis of variance (ANOVA). Results The baseline hand hygiene compliance rate was low at 15.6%, with the highest compliance (25.0%) for "After touching patient surroundings." Post-intervention, the overall compliance rate increased significantly to 36.0% (p < 0.001). Significant improvements were observed in moments "After body fluid exposure risk" (11.1% to 31.3%, p = 0.004), "After touching a patient" (12.0% to 52.9%, p = 0.006), and "After touching patient surroundings" (25.0% to 73.3%, p = 0.001). Dental hygienists, assistants, and trainee dentists showed significant increases in hand hygiene compliance, while dentists did not. Hand sanitizer consumption increased significantly from 2019 (2.38 ± 0.29 mL per patient) to 2020 (3.47 ± 0.49 mL, p < 0.001) and remained elevated through 2023. Conclusions This study revealed low baseline hand hygiene compliance in a dental university hospital setting. While direct observation and education led to significant short-term improvements, especially among allied health professionals, the disconnect between observed compliance rates and hand sanitizer consumption suggests these changes may not represent sustainable behavioral shifts. The varying improvement rates among different healthcare workers and the challenges in maintaining long-term adherence highlight the need for tailored, continuous interventions in dental education and practice settings to enhance hand hygiene compliance.

‘Who Sanitizes the Sanitizer?’: COVID Comics and Sanitisers

Much like face masks, hand sanitisers have become a household item and a prominent symbol since the COVID-19 pandemic. As sanitisers began to be widely used, contingent issues related to...

Preliminary study of triclosan analysis: A GC/ECD optimization

Abstract Triclosan is one of emerging contaminants with antimicrobial and disinfection properties. It is commonly used in soaps, toothpastes, detergents, hand sanitizers, disinfectants, and other personal care products. Triclosan is ubiquitous in environmental samples and its concentration in natural waters is drastically increase owing to the use of hand-sanitizer during COVID-19 pandemic. Triclosan cancer classification has not been determined yet, but recent studies and government assessments had shown its adverse effect, including as endocrine disruptor compound (EDC) to living things even at relatively low concentration. Triclosan analysis in environmental samples are mostly performed on LC/MS or GC/MS instruments. However, these instruments are relatively expensive. This study was aimed to optimize GC/ECD for triclosan quantification as an alternative to MS based instruments. Triclosan standard solutions at several concentrations were injected into the GC/ECD and the result is evaluated. The result showed that GC/ECD was able to detect triclosan at 0.1 ppb with good repeatability showed by %RSD of 0.48 %. The calibration curve at range of 0.1 to 1000 ppb showed a good linearity (r=0.99999).

Antibiotic resistance pattern of bacterial strains emerged using frequent hand sanitizers during corona pandemic.

Hands are in fact the main route of transmission of pathogenic infections. By using proper hand sanitization, we can break the virus's transmission chain, which is especially important in the ongoing COVID pandemic outbreaks. The effectiveness of hand sanitization is solely dependent on the use of sufficient antibacterial agents, which come in a variety of levels and types, including antimicrobials commercial, water-based, or alcohol-based hand sanitizer, the latter being widely used during pandemics. Therefore, the sudden overuse of sanitizers also could lead to an increase in the tolerance limit for normal hand flora and the new development of antimicrobial resistance (AMR). In this study, we investigated the relationship between hand sanitizer-tolerant bacteria and their antibiotic resistance profile to multiple antibiotic agents. On a timely basis before and after using different hand sanitizers, bacterial strains were collected from the volunteers of CSIR-Central Salt and Marine Chemicals Research Institute (CSIR-CSMCRI). Sanitizer tolerant bacterial strains were observed also just after the application of sanitizers, which also showed the AMR phenomenon. The resultant sanitizers' resistant microbiome showed the dominant presence of Bacillus sp., Staphyloccocus sp., Paenibacillus sp., Lysinibacillus sp., Exiguobacterium sp. and Leclercia sp. All 36 nos of bacterial strains showed MDR (> 5 nos).

Trends in the hand hygiene practices using alcohol-based hand rubs in Japanese hospitals before and after the novel coronavirus pandemic: an observational study using national surveillance data

Healthcare-associated infections (HAIs) are a global concern in healthcare facilities, and hand hygiene (HH) using alcohol-based hand rubs (ABHR) is fundamentally crucial for their prevention. While previous studies report improvements in HH compliance amid the COVID-19 pandemic, the real situation in Japanese medical settings remains unclear. This observational study sought data from the Japanese national surveillance, focusing on ABHR use in hospitals before and after the COVID-19 pandemic. Data were retrieved from facilities certified to receive the Additional Healthcare Reimbursements for Infection Prevention and Control I. The study spanned five years (2019-2023), segmented quarterly, and employed Joinpoint regression analysis to assess the annual percentage change (APC). Overall, ABHR use per patient per day significantly increased both in critical care units and general wards amid the pandemic. However, the APC in the critical care units demonstrated a downward trend from Q4 of 2021 to Q1 of 2023, and ABHR use in general wards remained below the amount of WHO recommendations. This trend analysis highlighted recent patterns of ABHR use in Japanese hospitals by comparing pre- and post-COVID-19 periods. Although increases in ABHR use were observed over time, sustained efforts to promote HH compliance are necessary, particularly in general wards.

Penyuluhan Kesehatan Bahaya ISPA dan Penerapan Perilaku Hidup Bersih dan Sehat (PHBS)

ARI is still a major health problem in Indonesia. The purpose of health counseling in RW 01 Kalibaru, Cilincing North Jakarta is to increase public awareness about the dangers of ARI and the importance of Clean and Healthy Living Behavior (PHBS). The methods used include interactive lectures, questions and answers, and demonstrations of making hand sanitizers. The activity was attended by 36 participants, the majority of whom were female (97.1%) with an age range of 21-65 years. To measure participants' understanding, an evaluation was conducted after the material was given. The results showed that 97.1% of participants had good knowledge about ARI and PHBS after the counseling was given. Participants were able to correctly answer questions related to the definition of ARI, symptoms, prevention, and principles of PHBS. In conclusion, this counseling is effective in increasing community knowledge about ARI and PHBS. It is expected that this better knowledge can encourage behavioral changes in the community.

Monkeypox (MPOX): Unmasking the Lesser-known Viral Threat

Monkeypox (Mpox) is caused by a viral infection and has been endemic in several African states after the last outbreak throughout the world in 2003. This disease resurfaced in the year 2022 and has since spread worldwide, even in countries where no cases had been reported in the earlier outbreak. While the world was still recovering from the menace of corona virus disease 2019 this virus; having similar features, started to spread across the world affecting thousands of people. The virus can be transmitted from human to human, and to humans from bites and scratches of infected animals. Common signs and symptoms include rashes and lymphadenopathy, accompanied with fever. Preventive measures for the Mpox virus include: using masks and alcohol-based hand sanitizers, practicing social distancing in crowded areas and practicing safe sexual activities. ACAM2000 and LC16m8 are a few vaccines available for its treatment. Early diagnosis and timely treatment of the disease have helped to curb the incidence and mortality of Mpox. Through this article, we discuss the history of infection, mode of transmission, the genomic data of the virus along with its signs and symptoms and its prevention and treatment using available vaccines. World governments and healthcare providers need to act appropriately in order to combat another such outbreak, as this disease has not been eradicated yet.

Implementation of COVID-19 infection control best practices in nursing homes amid the pandemic

BackgroundThe COVID-19 pandemic has claimed around 170,000 lives among nursing home residents and staff in the United States through April 2023. In a cluster randomized controlled trial (RCT) with 136 nursing homes, we delivered training to improve COVID-19 infection control best practices. We sought to assess the implementation of infection control practices in participating nursing homes.MethodsConcurrent with the delivery of the RCT (January-November 2021), we surveyed nursing home administrators (NHAs, n = 38) at baseline and 6-month follow-up. Using validated items from the Centers for Disease Control and Prevention (CDC), the surveys inquired about 80 infection control best-practice activities (yes/no). The survey also asked seven scales corresponding to inner setting factors that may have impacted implementation. We assessed changes in infection control practices and inner setting factors between baseline and 6-month follow-up.ResultsOverall, the implementation of 11 best practices changed over time. NHAs reported an increase in the availability of informational materials for residents and families (84% vs. 100%, p = 0.031), the use of alcohol-based hand sanitizer over soap (76% vs. 97%, p = 0.008), and the development of contingency plans for increased postmortem care (53% vs. 82%, p = 0.013). The implementation of four best-practice visitation policies and three communal restrictions decreased between baseline and 6-month follow-up (all p < 0.05). Regarding inner setting factors, only culture stress (perceived strain, stress, and role overload) increased between surveys (mean scores: 3.14 vs. 3.58, p = 0.004).ConclusionThis study was among the first to report changes in implementing COVID-19 infection control best practices in nursing homes amid the pandemic. Culture stress was an important inner setting factor that may have impacted implementation activities.Trial registrationNCT04499391Date of registrationAugust 3rd, 2020

Evaluating the tolerability and acceptability of a locally produced alcohol-based handrub and hand hygiene behaviour among health workers in Sierra Leone: a longitudinal hospital-based intervention study

BackgroundAlcohol-based handrub (ABHR) is the gold standard for hand hygiene (HH) and is a cornerstone of infection prevention and control (IPC) strategies. However, several factors influence the efficient use of ABHR by health workers. This study evaluated the tolerability and acceptability of a locally produced ABHR product and HH behaviour among health workers.MethodsA longitudinal hospital-based intervention study was conducted in accordance with the WHO’s standardized protocol for evaluating ABHR tolerability and acceptability (Method 1). Sixty health workers across 4 hospitals in Sierra Leone were observed over a 30-day period at three separate visits (days 1, 3–5, and 30) by trained observers. The outcomes of interest included skin tolerability and product acceptabilityevaluated using subjective and objective measures.ResultsObjective and subjective evaluations demonstrated strong skin tolerability and high acceptability with the product. At all three visits, the skin tolerability score assessed by trained observers was < 2 in ≥ 97% of participants, exceeding the WHO benchmark score (BMS = < 2 in ≥ 75%). Participants’ self-evaluations of overall skin integrity were 97% (visit 2) and 98% (visit 3) for scores > 4 (BMS = > 4 in ≥ 75%). The primary acceptability criteria increased up to 95% (colour) and 88% (smell) at visit 3 (BMS = > 4 in ≥ 50%). Despite high acceptability, the product’s drying effect remained low at 52% and 58% during visits 2 and 3, respectively (BMS = > 4 in ≥ 75%). There were positive HH behaviours (n = 53, 88%), with more than half (n = 38, 63%) of them exhibiting HH at almost every HH moment. The mean ABHR was notably high (76.1 ml, SD ± 35), especially among nurses (mean = 80.1 ml) and doctors (mean = 74.0 ml).ConclusionThe WHO-formulated, locally produced ABHR was well tolerated and accepted by health workers. These findings support the continuous utilization of evidence-based, cost-effective hand hygiene interventions in resource-limited settings. High handrub consumption and frequent HH practices were noticeable HH behaviours. Further research is recommended to optimize product formulations for skin dryness and investigate the association between ABHR consumption and hand hygiene compliance.

Assessment of Knowledge, Attitude, and Practice of Hand Hygiene Among Medical Students in a Tertiary Care Hospital.

Healthcare-associated infections (HCAIs) and emerging multi-drug resistance in nosocomial pathogens are perceived as a serious public health threat. Hands of healthcare workers (HCWs) become routinely colonized during patient care, serving as vehicles for transmission and leading to HCAIs.Hand hygiene (HH) is a globally accepted tool to avoid the broadcast of dangerous microorganisms and prevent HCAIs. A cross-sectional study was carried out to evaluate the knowledge, attitude, and practice toward HH among the medical students at Saveetha Medical College, Chennai, India. A 25-item validated questionnaire survey was formulated and circulated to100 medical students of all four academic years. There were 100 responses to the survey, and 44 (44%) participants performed HH appropriately for 20 seconds with alcohol-based hand rub. In our study, 25％ of the participants revealed that HH practices were not followed during emergencies. Many participants (40%) stated that the lack of sink, soaps, alcohol-based sanitizers, paper towels, and water is the reason for not performing HH. The gross knowledge of HH of the participants is moderate, but there were gaps between the knowledge and practice. Hence, it is essential to conduct structured training sessions and surveillance programs for medical students to address these gaps in knowledge and the correct HH procedures.