Handwashing Protocol Research Articles

Influencing Factors on Nurses' Hand Washing Compliance

Poor hand washing of nurses and unhealthy hospital environments contribute to the occurrence of nosocomial infections. Nurses who do not wash their hands before and after the procedure can become an intermediary for infection in patients at the service site or hospital and spread various multi-resistant organisms. This research aims to identify nurses' hand washing compliance and related factors. A descriptive correlation design was conducted in a hospital in West Java. Data on nurse characteristics and hand washing compliance were taken using a five moments test questionnaire cross-sectionally among nurses using the total sampling method and analyzed univariately and bivariately using descriptive analysis and the chi square test. A total of 67 nurses were involved in this research, the majority of respondents were aged 25-35 years (43/64.2%), women (42/62.7%), had a bachelor's degree (36/53.8%), had worked less than 5 years (42/62.7%) , lack of knowledge (35/52.2%), and have a positive attitude (38/56.7%), generally do not comply with hand washing protocols (34/50.7%). The nurse's age is related to hand washing compliance (p 0.002 < α 0.05), while gender (p 0.242), education (p 0.534), length of work (p 0.874), knowledge (p 0.907), and attitude (p 0.397) have α value > 0.05. Nurses' hand washing compliance is still less than the target. Age is related to nurses' compliance in implementing hand hygiene. Meanwhile, gender, education, length of work, knowledge and attitudes are not related to nurse compliance. Efforts are needed to increase nurses' knowledge to increase nurses' compliance in washing hands.

Knowledge and Practices of Nurses Regarding Aseptic Techniques for Infection Prevention in Operating Room at Tertiary Care Hospital

Background: Surgical site infections (SSIs) remain a significant concern in operating rooms, largely influenced by the adherence to aseptic techniques by healthcare professionals. Despite the critical role of operating room nurses in preventing these infections, gaps in knowledge and practice persist, affecting the overall quality of patient care in tertiary healthcare settings. Objective: This study aimed to assess the knowledge and practices of operating room nurses regarding aseptic techniques for infection prevention in tertiary care hospitals. Methods: A descriptive cross-sectional study was conducted at a tertiary care hospital in Lahore, involving 130 operating room nurses with over a year of service. The study employed purposive sampling to administer a validated questionnaire assessing demographic data, knowledge, and practices related to aseptic techniques. Data were collected from January to March 2023 and analyzed using SPSS version 25, employing descriptive and inferential statistics to explore the relationship between demographic factors and knowledge/practices of aseptic techniques. Results: The study found that 60% of nurses were aware that a gown is considered sterile in specified areas, and 54.6% understood the contamination risks of dropped sterile packages. Approximately 62.3% recognized the importance of maintaining a safe distance during procedures. Despite these knowledge indicators, 94% of nurses routinely practiced sterile techniques, and 91% adhered to proper handwashing protocols. However, the overall level of knowledge concerning aseptic techniques was low, with significant gaps that could potentially impact patient safety. Conclusion: The study highlights a discrepancy between the knowledge and practices of operating room nurses regarding aseptic techniques, indicating a critical need for enhanced training and continuous education to bridge these gaps and improve infection control measures in surgical settings.

Unveiling Indian Coping Tactics for Neurobehavioral Disorders in COVID-19 Confinement

The COVID-19 Pandemic brought an increase in Mental Health Problems for the general population, but the most substantial phase was for people who had Pre-existing Neurobehavioral Disorders, especially Adolescents and Children. As the COVID-19 Confinement Policies brought a lot of problems in Medication Adherence, Interventions, Assessment and Diagnosis of the patients with Neurobehavioral Disorders. The adoption of virtual support tools and online platforms for patients with neurobehavioral disorders in India during the pandemic is highlighted in this review. Some of the Neurobehavioral Disorders, such as Attention Deficit Hyperactivity Disorder (ADHD), have both positive and negative effects with home confinement. The Text-Message based Disorder monitoring approach is used for ADHD patients. In patients with Autism Spectrum Disorder (ASD), where Online Diagnosis Tools are used for intervention. The children with Intellectual Disability (ID) faced problems understanding the hand washing protocols for the COVID-19 pandemic, though parents were advised to use visual charts for making the children understand hand washing protocols. Obsessive Compulsive Disorder (OCD) symptoms got worse with home confinement. Patients with Multiple Sclerosis (MS) have sleep cycle disturbances and sleeping difficulties. Education and Awareness Campaigns on coping strategies for families and caregiver through online platforms, maintaining medication adherence for patients with neurobehavioral disorders has become a key link to reduce the impact of disrupted routines and limited physical activities on patient’s symptoms.

Anambra State Residents’ Attitude towards Radio Campaigns Messages on Compliance to Covid-19 Protocols

The study examined Anambra state residents’ attitude towards radio campaign messages on compliance to covid-19 protocols, with the objectives includes: to determine the level of awareness of Anambra state residents to radio campaigns messages of covid-19 protocols; to determine the extent radio campaigns influenced residents’ compliance to use of face masks and to ascertain the level of influence of radio campaigns on residents’ compliance to hand washing etiquette. The forms of delivering the campaigns considered were radio jingles, radio dramas, public service announcements, and sponsored health talks. The Population for the study was 5,932,516, four hundred (400) participants were surveyed across six (6) purposively selected local government areas in Anambra State. The study found that majority of the residents are highly aware and knowledgeable about COVID-19 radio campaign messages. The study also found that the radio campaign messages has highly influenced the audience to use face masks and also adhere to hand washing protocol.

Washing with dirty waters: Awareness, perceptions and challenges of hand hygiene during the COVID-19 pandemic in Nigeria’s informal urban communities

Studies have emphasized the implications of the lack of adequate handwashing facilities for the campaign against COVID-19 in many communities. However, peoples’ awareness and perceptions of the handwashing protocol have received little or no scholarly attention. This study examined the awareness, perceptions and challenges of hand hygiene in three informal urban settlements in Nigeria: Mararaba, Makoko, and Waterfront. Data wereobtained from 30 participants from these settlements. Using a deductive analytical approach, the study found that the level of awareness and compliance with the handwashing protocol is very low. The few participants who occasionally wash their hands do so with dirty water. Findings also showed that there is gross inadequacy of handwashing facilities in the studied communities. Implications of findings for COVID-19 governance and policies are discussed.

Carbapenem-resistant IMP-1-producing Pseudocitrobacter vendiensis emerging in a hemodialysis unit.

Hemodialysis patients are at high risk for bloodstream infections associated with highest morbidity and mortality rates. Bacterial species not commonly related to such infections has been hardly identified by traditional methods. Pseudocitrobacter is a novel genus of the order Enterobacterales that is associated with carbapenemase genes and nosocomial infection. In this context, we have investigated nine cases of bloodstream infections by carbapenem-resistant Gram-negative bacilli in patients assisted at a hemodialysis unit in Brazil. The infections were caused by a metallo-β-lactamase (IMP-1)-producing clone (> 90% XbaI-PFGE similarity) of Pseudocitrobacter vendiensis, displaying a multidrug-resistant profile to broad-spectrum cephalosporins, carbapenems, chloramphenicol, and trimethoprim-sulfamethoxazole. S1-PFGE and Southern blot hybridization revealed that blaIMP-1 was carried by a 200-kb IncC/ST3 plasmid. Patients were successfully treated with amikacin, and strict disinfection procedures and hand washing protocols were reinforced. We report the emergence of P. vendiensis, a recently described species of the genus, in bloodstream infections of patients undergoing hemodialysis. Considering the epidemic potential of carbapenemase-producing Enterobacterales in hospital settings, surveillance of this emerging pathogen is of utmost importance.

Love Thy Neighbour? Perceived Community Abidance and Private Compliance to COVID-19 Norms in India

To arrest the spread of COVID-19 infection, strict adherence to frequent hand washing and respiratory hygiene protocols have been recommended. While these measures involve private effort, they provide health gains along with collective community benefits and hence are likely to be driven by pro-social motives like altruism and reciprocity. Using data from 934 respondents collected from April till May 2020 across India, we assess if changes in perceived community compliance can predict changes in individual compliance behaviour. We observe statistically significant and positive relationship between the two, even after accounting for observable and omitted variable bias allowing us to view the results from a plausible causal lens. Further, we find subsequent lockdowns having a detrimental effect on individual compliance though the gains from higher perceived community compliance seem to offset this loss. We also find positive perceptions about community can be particularly effective for people with pre-existing co-morbidities. Our findings underscore the need for multi-level behavioural interventions involving local actors and community institutions to sustain private compliance during the pandemic. We suggest these interventions need to be specially targeted for individuals with chronic ailments and emphasize on community behavioural practices in public messaging.JEL Codes: I12, I18, I19, I31

COVID-19 and handwashing: Implications for water use in Sub-Saharan Africa.

Because the main modes of transmission of the COVID-19 virus are respiration and contact, WHO recommends frequent washing of hands with soap under running water for at least 20 s. This article investigates how the level of concern about COVID-19 affects the likelihood of washing hands frequently in sub-Saharan Africa. We discuss the implication of the findings for water-scarce environment. The study makes use of a unique survey dataset from 12 sub-Saharan African countries collected in April 2020 (first round) and May 2020 (second round) and employs an extended ordered probit model with endogenous covariate. The results show that the level of concern about the spread of the virus increases the likelihood of washing hands with soap under running water for a minimum of 20 s at least five times a day. The increase in the probability of handwashing due to concern about COVID-19, ranges from 3% for Benin to 6.3% for South Africa. The results also show heterogeneous effects across gender- and age-groups, locality and various water sources. However, in Africa, the sustainability of the handwashing protocol could be threatened by the severe water scarcity that exists in the region. To sustain frequent handwashing, sub-Saharan Africa needs an effective strategy for water management and supply.

A Study to Assess Hand washing compliance among nursing professionals in General Wards of Pondicherry Institute of Medical Sciences

Hand washing is the practice, which keeps the hands free from pathogens or decrease the amount prior to any procedure or touching the patient. Health Care associated infections (HCAIs) are the major cause of morbidity and mortality. Hospital acquired infections posses a very real and serious threat to all who are admitted in hospitals. Evidence based guidelines for Health Care Workers hand hygiene practice exist, but compliance with these are internationally low (Creedon, 2005)1. The design adopted for the study was Descriptive design. The study was conducted in all the General medical and surgical wards. Census method was used to collect the data. 116 nurses were working in general wards of PIMS out of which 113 nurses participated in the study. Among 113 Nurses, 69.9% (79) had average compliance to hand washing practices, 21.2% (24) had good hand washing practices and 8.8% (10) had poor washing practices and the reasons for non-compliance to hand washing practices. 7.1% said they were too busy, 2.7% just forgot and 1.8% said the materials were not available. The results revealed that compliance to hand washing practices was average among nurses and there is a need to reinforce the use of standard hand washing protocols available in their wards.

Haiti's Cholera Epidemic: When the Unexpected Must be Expected

Cholera has been around for centuries but in our modern history there has been a resurgence with at least 7 devastating global outbreaks occurring worldwide in in the last century each claiming thousands of innocent lives. Cholera infects 1.3 to 4 million people around the world, killing 21,000 to 143,000 people annually according to the World Health Organization (WHO). It is thus imperative to research this bacterial disease and come up with ways of shedding light on effective prevention and cure. Cholera is an illness of multi-causal origin where biological, environmental, social, political, and cultural factors intervene. This disease continues to resurge as a sanitary problem of great magnitude in many countries and emerged in Haiti following the January 12, 2010 magnitude 7.0 earthquake some 16 miles from the capital city of Port-au-Prince, where it caused massive damage to roads, buildings, and the environment. Although Haiti is among the poorest countries in the Americas, and its capital city lacked much in the way of modern public sanitation at the time of the earthquake, the country had been cholera free for at least 150 years or more at the time of the earthquake. By mid-October 2010, the first cases of cholera began to appear, and by the end of the decade would infect some 800,000 Haitians (~10% of the population of Haiti) and approximately 10,000 deaths. The source of the infection was traced to the Artibonite River, a main source of water in Haiti, which was believed to have become unknowingly contaminated by well-intentioned foreign workers from Nepal following the earthquake. The strain of cholera found in Haiti was similar to the one found in Nepal (CDC). Haiti employed measures of Cholera prevention and eradication efforts including water treatment, sanitation and hygiene measures, education, oral vaccination, and addressing climate variability issues, history, epidemiology, clinical diagnosis, and treatment, monitoring and prevention of this disease to prevent further loss of life. By 2020, no new cases of cholera have been reported for over 12 months, indicating that Haiti may soon be cholera free once again. Results/Conclusion: Effective hygienic conditions, timely medical intervention including supportive care, access to the appropriate antibiotics, availability of clean drinking water, hand washing, and other prevention protocols can help curb the loss of life associated with cholera. Cholera can kill a healthy person within 12 to 24 hours from the onset of diarrhea, as it is quite virulent. The current situation of cholera in the world (particularly in Haiti), and the extensive collaborative relation and the geographical proximity to Haiti makes the epidemiological risk in neighboring countries increase; therefore, immediate action is required in the organization of health services to prevent yet another epidemic.

Impact of the coronavirus disease 2019 pandemic on periodontal practice: A questionnaire survey.

AimThis cross‐sectional study sought to investigate the factors possibly related to the impact caused by the coronavirus disease 2019 pandemic in the practice of periodontists, in two countries.Materials and methodsA total of 254 periodontists with active periodontics licensing in Brazil and the United States participated in the survey. Data were collected through an online questionnaire and the dependent variable was the perceived impact of the pandemic on periodontists' practice routines. Odds ratios were assessed by logistic regression analysis.ResultsPeriodontists in private practice were 83% less likely to report a significant impact of the pandemic on their clinical routine as compared with professionals who work in the public sector or in academic institutions (CI 95%: 0.05–0.47). The financial impact of the pandemic was significantly associated with a perceived severe impact of the pandemic on their routines (OR: 1.36; CI 95%: 1.16–1.61). Professionals who have enhanced their hand‐washing routine were more likely to report a significant impact of the pandemic by 3.41 times (CI 95%: 1.28–9.04) relative to those who have not altered their hand‐washing protocols.ConclusionThe pandemic is associated with a negative impact on the practice of periodontists, especially those working in public sectors and academic institutions.

Coronavirus Disease 2019 (COVID-19) Infection

Coronavirus Disease 2019 (COVID-19) Infection

Compliance with the handwashing protocol by nursing professionals in a health service of the city of Encarnacion, March-July 2019

Compliance of handwashing protocol avoid nosocomial infections, while non-compliance causes consequences such as increased morbidity and mortality, hospital stay, additional cost to the health system and the patient. This can be prevented with handwashing which emerged as a theory in ancient times. This study was descriptive observational with quantitative approach and was carried out in 24 nurses at a health service in the city of Encarnacion in order to evaluate the compliance of handwashing protocol, established in the Infection Prevention and Control Manual associated to Health Care of 2017 of the Ministry of Health Care and Social Welfare. The results showed 54% of non-compliance in the handwashing technique, 44% of partial non-compliance and just 2% of compliance. In relation to the five moments of handwashing technique, 85% did not follow all the steps and 70% did not receive training regarding to the hand washing technique in the last 2 years. A high percentage of non-compliance with the hand washing technique protocol was evidenced, which represents a health risk, which can be corrected with training or feedback workshops for nursing professionals

Nurses’ Attitudes and Perceptions towards Hand Hygiene in Mental Health and Medical Inpatient Settings: Comparative, Cross-Sectional Study

Poor hand hygiene is a major contributor to hospital acquired infection. In this study, a comparison of the related attitudes of psychiatric and non-psychiatric nurses was made using a cross-sectional survey design. N = 79 nurses who work in psychiatric or non-psychiatric hospital wards completed questionnaires regarding intended compliance with hand-washing protocols and potential cognitive predictors of compliance. Perceived ease of compliance and behavioural norms, and working in a non-psychiatric ward, predicted superlative intended compliance. Working in psychiatry did not in itself predict outgroup membership suggesting that psychiatric ward-related factors, rather than psychiatric nurse-related factors are most relevant in determining between-group differences. Consideration of factors unique to psychiatry wards during service design could improve compliance.

MP58-17 PREVALENCE OF POSITIVE SEMEN CULTURES OF SPERM BANKED SPECIMENS

INTRODUCTION AND OBJECTIVE: Semen culture is routinely obtained prior to in-vitro fertilization (IVF), and efforts to treat positive cultures are important to optimize success. Leukocytospermia and bacteriospermia′s influence on semen and fertility is widely debated. Currently no guidelines on the role of semen culture before sperm cryopreservation exists. Survival of bacteria after cryopreservation has been reported in the literature. The goal of this study was to assess the prevalence of positive semen cultures and define the role of culture prior to cryopreservation. METHODS: Retrospective review was conducted on men with cryopreserved specimens over a 10 month period. Genital Benzalkonium chloride wipe was added to standard hand washing protocol after 8 months. An incubating solution containing Gentamicin for cryopreservation was used. Demographics, semen parameters, and semen culture results with organisms and antibiotic sensitivity were recorded. RESULTS: 63 men provided ejaculated semen for cryopreservation. Mean age was 30.5±10.4 years. 33 men cryopreserved because of malignancy, 14 for sub-fertility, 7 were transgender, and 9 were for other reasons. 36 men (57.1%) had positive semen cultures and 27 men (42.9%) had negative cultures. Potential pathogenic bacteria were found in 25 men (69.4%) with positive culture; enterococcus (8) and β-hemolytic streptococcus (7) were most common. 16 men (44%) had non-pathogenic bacteria, coagulase negative staph (13) was most common. 17 men had bacteria not sensitive or not tested against Gentamicin, 25 men had Gentamicin sensitive bacteria. After institution of genital wipes, 9 out of 20 men (45%) had positive culture. 43 men provided a sample prior to addition of the genital wipe, and 27 men (62.8%) had a positive culture. No differences were found with culture positivity before or after use of genital wipes, p>0.05. No differences were found when comparing semen parameters and leukocytes between positive and negative semen cultures. CONCLUSIONS: Greater than 50% of men cryopreserving semen had positive cultures with over 69% harboring a potentially pathogenic organism, many of which are not sensitive to Gentamicin. Semen parameters and seminal leukocyte presence were not indicative of culture positivity. The institution of a hand washing protocol did not change the frequency of positive cultures. Work is needed to assess the survivability of bacteria after thawing and evaluation of the effect of culture positivity on IVF. Source of Funding: None

COVID-19 / Coronavirus Outbreak: Guidance for Hand Hygiene for Healthcare Providers to Ensure a Safe and Healthy Environment

Handwashing is an easy and simple way for healthcare providers to maintain a safe and healthy environment for both themselves and the patient. The following handwashing protocol should be used before and after patient contact.

Impact of hand hygiene knowledge on the hand hygiene compliance.

Aim Hand hygiene practice is still burdened by inadequate compliance, whether in the professional sphere by health professionals or in the non-professional sphere by lay population. Aim of this study was to map the hand hygiene knowledge and its compliance in the monitored group of people. Methods The research was conducted at the Jessenius Faculty of Medicine in Martin of Comenius University in Bratislava (JFM CU) among seventy 3rd year students of General Medicine (medical study program), and Nursing, Midwifery and Public Health (non-medical study programs). Knowledge of hygienic hand washing according to the WHO guidelines from 2009 was investigated, as well as differences in the level of microbial contamination of hands after routine hand washing between the group that had been acquainted with hand hygiene protocols and the group that had not sufficiently. Results The results have shown that 32.9% of the students did not perform hygienic hand washing properly. The differences between the groups of students with and without the proper hand hygiene compliance in routine hand washing were not statistically significant. Conclusion The results of our survey have suggested that the reasons for decreased compliance with hand washing protocols may be related to forgetting to wash the hands or not being acquainted with hand washing protocols at all. The strategies focused only on one aspect of hand hygiene are, according to scientific literature, ineffective in the long term.

Health facility preparedness for cholera outbreak response in four cholera-prone districts in Cameroon: a cross sectional study

BackgroundThe risk of cholera outbreak remains high in Cameroon. This is because of the persistent cholera outbreaks in neighboring countries coupled with the poor hygiene and sanitation conditions in Cameroon. The objective of this study was to assess the readiness of health facilities to respond to cholera outbreak in four cholera-prone districts in Cameroon.MethodologyA cross-sectional study was conducted targeting all health facilities in four health districts, labeled as cholera hotspots in Cameroon in August 2016. Data collection was done by interview with a questionnaire and by observation regarding the availability of resources and materials for surveillance and case management, access to water, hygiene, and sanitation. Data analysis was descriptive with STATA 11.Principal findingsA total of 134 health facilities were evaluated, most of which (108/134[81%]) were urban facilities. The preparedness regarding surveillance was limited with 13 (50%) health facilities in the Far North and 22(20%) in the Littoral having cholera case definition guide. ORS for Case management was present in 8(31%) health facilities in the Far North and in 94(87%) facilities in the littoral. Less than half of the health facilities had a hand washing protocol and 7(5.1%) did not have any source of drinking water or relied on unimproved sources like lake. A total of 4(3.0%) health facilities, all in the Far North region, did not have a toilet.ConclusionsThe level of preparedness of health facilities in Cameroon for cholera outbreak response presents a lot of weaknesses. These are present in terms of lack of basic surveillance and case management materials and resources, low access to WaSH. If not addressed now, these facilities might not be able to play their role in case there is an outbreak and might even turn to be transmission milieus.

A MINUTE TO CLEAN IT”: COMPLIANCE TO HAND WASHING PRACTICE AMONG HEALTHCARE WORKERS IN ILIGAN CITY

Background:Healthcare-associated infections are the most common adverse event in healthcare, resulting in a significant burden on patients, their families, and health care systems. Hand hygiene is the leading measure for preventing the spread of pathogens and reducing health care associated infections, but health care providers’ adherence to recommended practices remains suboptimal in most settings, and (improvement) maintaining its standards is difficult to sustain.Objective: This study attempts to explore the degree of compliance among nurses and nursing attendants in the strict implementation of the standards in hand washing practices. Methodology: Quantitative-quasi-experimental design was used to measure their degree of compliance of proper hand hygiene. Using a questionnaire based on the World Health Organization’s “My Five Moments of Hand Hygiene”. Convenience sampling was used in choosing 50 nurses and nursing attendants in selected wards of a hospital in Iligan City. Weighted Mean and Spearman-Rank Correlation was used as statistical tool. The data was encoded for analysis using the IBM-SPSS version 20 software. This study showed that out of the five moments of hand hygiene, (After Body Fluid Exposure Risk Moment) was the most practiced moment of hand washing. This is followed by the (After Touching the Patient Moment). The (Before Clean/ Aseptic Procedure Moment) and (After Touching Patient Surrounding Moment) was tied on third place. Only the (Before Touching a Patient Moment) fell into the “frequently” parameter. The study implies that the respondents were usually compliant to hand washing practices. Strict monitoring and implementation of hand washing protocol must be constantly observed.

Dead mouse hopping: Tyzzer’s disease in spinifex hopping-mice (Notomys alexis)

Tyzzer’s disease is caused by Clostridium piliformes and affects a wide range of domestic and wildlife species. Non-descript signs, if any, and a short incubation period make Tyzzer’s disease difficult to diagnose and treat before death occurs. Here we describe an unexpected outbreak of Tyzzer’s disease in a colony of native Australian spinifex hopping-mice (Notomys alexis).In this study captive hopping-mice were used in a nutrition trial (n=11), and others were housed in close proximity (n=4). During the nutrition trial, two hopping-mice exhibited signs of lethargy and diarrhoea, and were removed from the trial but died soon after. Other hopping-mice exhibited limited clinical signs of ill-health, prior to their death. In total four animals were found dead, and another seven were euthanised, to prevent a potential disease outbreak. Tyzzer’s disease was confirmed post-mortem using histopathology silver stain to detect the bacilli-shaped bacteria (C. piliformes) in liver tissue of two hopping-mice. After Tyzzer’s disease was confirmed enhanced infection control measures were implemented. Enhanced control measures included the use of metal containers for food and water, sick animals were fed and cleaned last, 5% sodium hypochlorite was used as the cleaning agent, stricter hand washing protocols and a change of gloves between feeding animals, and strict limits on persons entering the facility.Control measures for this disease should include euthanasia of any animals suspected to be infected, complete disinfection of all enclosures and associated equipment using sodium hypochlorite. Molecular methods could be employed to ensure complete removal of bacterial spores prior to new animals being moved into enclosures where affected animals were housed. Tyzzer’s disease is a fast spreading disease which can cause detrimental effects to captive colonies and their environment. Captive colonies subjected to stress are at risk of Tyzzer’s disease. Appropriate quarantine procedures, close montoring and quick action in response to signs of illness will ensure Tyzzer’s disease outbreaks do not occur.