Hand Hygiene Research Articles

Million Microfiber Releases: Comparing Washable and Disposable Face Masks.

The extensive use of single-use or disposable face masks has raised environmental concerns related to microfiber contamination. In contrast, research on the potential release and ecological impact of microfibers from washable masks (WMs), suggested as an eco-friendly alternative, is currently lacking. Here, we comprehensively investigated the release of microfibers from disposable and WMs of different types in simulated aquatic environments and real-life scenarios, including shaking, disinfection, hand washing, and machine washing. Using a combination of wide-field fluorescence microscopy, He-ion microscopy, and confocal μ-Raman spectroscopy, we revealed that disposable masks (DMs) released microfibers ranging from 18 to 3042 microfiber/piece, whereas WMs released 6.1 × 104-6.7 × 106 microfibers/piece depending on the simulated conditions above. Another noteworthy finding was the observed negative correlation between microfiber release and the proportion of reinforcement (embossing) on the DM surfaces. Microfibers from tested DMs primarily comprised polypropylene (PP), while WMs predominantly released poly(ethylene terephthalate) (PET) and cellulose microfibers. Furthermore, acute toxicological analyses unveiled that PP microfibers (0.01-50 mg/L) from DMs impacted zebrafish larval swimming behavior, while PET microfibers from WMs delayed early-stage zebrafish hatching. This study offers new insights into the source of microfiber contamination and raises concerns about the environmental implications linked to the use of washable face masks.

THE STYLISTIC ANALYSIS OF PAKISTANI HAND WASH ADVERTISEMENTS DURING COVID-19

The study focused on style of advertising language used in Pakistani hand wash products’ audiovisual advertisements during COVID-19 to explore what is conveyed through visual, musical, verbal, and nonverbal features, and how it is conveyed to the target audience through the use of linguistic & figurative devices. Guy Cook’s (1992) model ‘describing TV advertisements’ recommended in his book discourse of advertising was used as a theoretical framework for the investigation of the link between verbal, visual, image, & music used in audiovisual advertisements to target audience. The findings showed that hand wash products’ advertisements were full of creativity and for marketing perspective they used diverse verbal and nonverbal features to arouse interest, attract attention, create conviction, stimulate desire, and get action from the target group in the COVID-19 context. The results offer significant information in extracting the desired outcomes and reaching the conclusion & making decision. In this drive, the study can be advantageous for those who want to understand the socio-pragmatic functions of language in AV advertisements through a stylistic lens from commercial to academic perspective.

Study of hygienic hand disinfection of staff and dental students at the Medical University – Plovdiv

<b>Introduction:</b> Transient microbial flora on the hands of medical personnel is a prerequisite for healthcare-associated infections. Unlike permanent this micro flora can be removed by washing and disinfection. The hands of the dental staff are factor number one in the transfer of microorganisms: from patient to patient as well as on objects from the dental environment.<br /> <b>The aim</b> of the present study was to microbiologically examine hand washes of 5th year dental students and medical staff before starting work with a patient in order to evaluate the quality of hygienic disinfection performed.<br /> <b>Methodology:</b> The hands of a total of 115 doctors and students from the Faculty of Dental Medicine of the Medical University of Plovdiv were wiped with a sterile swab after treatment with a disinfectant. Isolates were identified to species using Vitek MS and MALDI-TOF technology.<br />  <b>Results: </b>Coagulase-negative staphylococci with a microbial number of 10<sup>3</sup>-10<sup>4</sup> were found to have the highest microbial count (70%). 9% of the samples with coagulase-negative staphylococci had microbial count ≥10<sup>5</sup>. The most common isolates detected were: <i>Staphylococcus hominis</i>, <i>Staphylococcus epidermidis</i> and <i>Micrococcus luteus</i>.<br /> <b>Conclusion:</b> The presence of coagulase-negative staphylococci in a high microbial count, enterococci and representatives of <i>Bacillus simplex</i> is undesirable, especially in immunosuppressed patients. These results highlight the need to increase knowledge about hand disinfection and its actual application before working with a patient.

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.

A Study to Assess the Effectiveness of Informative Booklet Regarding Knowledge, Attitude and Practice Among Intensive Care Unit (ICU) Staff Nurses Regarding Prevention of Central Line Associated Blood Stream Infection (CLABSI)

Background: Nurses in Intensive Care Units (ICU) have a vital role in reducing Central line associated blood stream infections (CLABSI) if they are well educated to use strategies to decrease Central line associated blood stream infections (CLABSI) rate which are based on the center for disease control and prevention guidelines (CDC) to improve patient’s outcomes. Health-care-associated infections are a huge concern in the intensive care units (ICUs) across the globe. Nearly 90% of catheter-related bloodstream infections are caused by central venous catheters (CVCs). Central venous catheters (CVC) are commonly inserted in critically ill patients and play an important role for hemodynamic monitoring and delivery of crucial treatments. Central line-associated bloodstream infection (CLABSI) is a laboratory confirmed bloodstream infection occurring in a patient with a CVC in place for >48 hours that is not related to an infection at any other site. Preventing nosocomial infections pose a great challenge in ICU, because of the multi-drug resistant organisms treated with broad-spectrum antibiotics. Clinical practice guidelines from various organizations are available for prevention of vascular catheter related infections. The Institute for Healthcare Improvement has introduced a “central line bundle” that includes the five best evidence-based practices to prevent CLABSI. This bundle includes hand hygiene, maximal barrier precautions during catheter insertion, skin antisepsis with chlorhexidine, optimal selection of the catheter site, with avoidance of the femoral vein and a daily assessment of line necessity, including the removal of an unnecessary line. Of these components, “hand hygiene” (HH) is the most convenient and cost effective to follow. “Hand Hygiene” HH prevents the transmission of pathogens and is a universal strategy to prevent all nosocomial infections. The World Health Organization has proposed a multimodal strategy; which includes five elements called the “Five Moments for Hand Hygiene”, as an evidence-based approach to prevent hospital-acquired infections. The five moments include, before touching the patient, before performing any a clean/aseptic procedure, after exposure/risk of body fluid, after touching the patient and after touching the patient surroundings. Therefore, the researcher was curious to know the effectiveness of informative booklet regarding knowledge, attitude and practice of intensive care unit staff nurses regarding prevention of central line associated blood stream infection (CLABSI).

Assessment of Knowledge, Perception, and Compliance with Hand Hygiene Practice among Health Care Workers at National Liver Institute, Menoufia University

Assessment of Knowledge, Perception, and Compliance with Hand Hygiene Practice among Health Care Workers at National Liver Institute, Menoufia University

Assessment of the operational facilities and hygienic practices of abattoirs and butcher shops in Ethiopia

Most meat-borne outbreaks are attributed to contamination due to poor handling practices and incomplete operational facilities in the meat supply chain. A cross-sectional study, using a structured questionnaire interview and observational checklist, was conducted to assess the hygienic practices of workers from abattoirs and butcher shops and the operational facilities in the area. A total of 286 randomly selected workers from 236 butcher shops and 3 abattoirs participated in this study. The results showed that at the abattoirs, isolation pens for sick animals, stunning boxes, separate rooms for carcass and offal, cooling equipment, and laboratories were missing facilities. Inhumane stunning, inadequate hand washing, insufficient trained workers, irregular medical checkups, and unspecified roles in the slaughtering process were practices that led to the unhygienic handling of meat. At butcher shops, hand washing after meat handling (97.9%), storing leftover meat in refrigerators (80.9%), concrete/tile floors (94.5%), and white-painted walls were good practices observed. Displaying meat at room temperature, wrapping meat with plastic bags, and newspapers, and untrained workers (82.6%) were practices that could compromise the quality of meat. Training was the only factor significantly associated with the hygienic practice of workers both at abattoirs (p = 0.023) and butcher shops (p = 0.012). Our study identified substandard facilities and unhygienic practices both at abattoirs and butcher shops that lead to microbial contamination of meat, which could be enhanced through improving operational facilities, training, and implementation of quality control systems.

Implementation of Five Moments of Hand Hygiene in the Inpatient Wards of Aceh Government General Hospital

Implementation of Five Moments of Hand Hygiene in the Inpatient Wards of Aceh Government General Hospital

Application of the behaviour-centred design to understand facilitators and deterrents of hand hygiene among healthcare providers: findings from a formative phase of a cluster randomised trial in the Kampala Metropolitan area

BackgroundHand hygiene is known to reduce healthcare-associated infections. However, it remains suboptimal among healthcare providers. In this study, we used the Behaviour-centered Design approach to explore the facilitators and deterrents to hand hygiene among healthcare providers in the Kampala Metropolitan area, Uganda.MethodsWe conducted a formative qualitative study as part of a cluster randomised trial in 19 healthcare facilities (HCFs). The study used 19 semi-structured and 18 key informant interviews to collect data on hand hygiene status and facilitators and deterrents of hand hygiene. Research assistants transcribed verbatim and used a thematic framework aided by Nvivo 14.0. to undertake analysis. We used thick descriptions and illustrative quotes to enhance the credibility and trustworthiness of our findings.ResultsAbout 47.4% of the HCFs had sufficient hand hygiene infrastructure, and 57.9% did not report total compliance with hand hygiene during patient care. The physical facilitator for hand hygiene was the presence of constant reminders such as nudges, while the biological included the frequency of patient contact and the nature of clinical work. The only biological deterrent was the heavy workload in HCFs. The executive brain facilitators included knowledge of workplace health risks, infection prevention and control (IPC) guidelines, and a positive attitude. A negative attitude was the executive brain deterrent to hand hygiene. Recognition, rewards, and fear of infections were the only motivated brain facilitators. Behavioural setting facilitators included proximity to functional hand hygiene infrastructure, the existence of active IPC committees, good leadership, and the availability of a budget for hand hygiene supplies. Behavioural setting deterrents included the non-functionality and non-proximity to hand hygiene infrastructure and inadequate supplies.ConclusionsThe study revealed low compliance with hand hygiene during the critical moments of patient care and inadequacy of hand hygiene infrastructure. The deterrents to hand hygiene included a heavy workload, negative attitude, inadequate supplies, non-functionality, and long distance to hand washing stations. Facilitators included constant reminders, fear of infections, frequency of patient contact and nature of clinical work, positive attitude, knowledge of IPC guidelines, recognition and reward, good leadership, availability of budgets for hand hygiene supplies, availability and proximity to hand hygiene supplies and infrastructure and active IPC committees.Trial registrationISRCTN Registry with number ISRCTN98148144. The trial was registered on 23/11/2020.

Evaluation of a Video-Based Concept for Hand Hygiene Education of Parents in a Neonatal Intensive Care Unit.

Current clinical guidelines support family-centered care in Neonatal Intensive Care Units (NICUs). This implies parents should also be involved in the most critical patient safety measures. Hand hygiene is the single most important tool to prevent healthcare-associated infections and related long-term effects. Although often studied in healthcare workers, the hand hygiene compliance of parents is rarely assessed. The aim of this study was to evaluate the effectiveness of an educational video, available in ten different languages, in teaching parents hand hygiene techniques in a NICU, lowering the burden on the staff. Parents in the intervention group were educated through a video; the control group received personal instruction from healthcare workers. The primary outcome parameter was the predicted probability of passing a subsequent hand scan. The quality of hand hygiene among parents educated through the video was at least as good as that of those who received instruction from a healthcare worker, demonstrated by a higher predicted probability of passing the hand scan (43.8% vs. 57.1% in male and 67.9% vs. 75.9% in female participants). The feedback from the intervention group was predominantly positive, with most parents (62%) expressing a preference for video-based education. Implementing a video-based approach seems to be effective for educating parents about hand hygiene in a NICU and was well accepted by the parents. This method offers a consistent standard of hand hygiene education, helps to overcome language barriers, and can also be used as regular reminder of the importance and proper technique of hand hygiene.

Knowledge, attitudes, and readiness about critical antimicrobial resistant organisms among healthcare workers at colonial war memorial hospital in Fiji: a pre and post intervention study

BackgroundGram-negative bacteria resistant to carbapenems are also known as critical antimicrobial resistant organisms. Their emergence at Colonial War Memorial Hospital (CWMH), the largest hospital in Fiji, is a major clinical concern. This study was conducted to determine the knowledge, attitudes, and readiness of healthcare workers (HCW) at CWMH regarding management of patients with infections caused by critical antimicrobial resistant organisms.MethodsA questionnaire was designed using a Likert scale to assess knowledge, attitudes, and readiness. Two cross-sectional studies were conducted, before and after the implementation of targeted educational activities which were informed by the pre-intervention study findings.ResultsA total of 393 and 420 HCW participated in the pre- and post-intervention studies, respectively. The majority of respondents were female (77.3%) and 18–34 years of age (67%). HCW professional roles included nurses (56.3%), doctors (31.6%), and laboratory personnel (12.2%). In the post-intervention study, significantly more HCW reported having received infection prevention and control (IPC) and antimicrobial resistance education and training (26.8% in pre to 45.5% in post intervention, p < 0.001). The majority of nurses and doctors (> 85% to ≥ 95%) were aware of how AMR organisms spread in healthcare settings and knew the IPC measures to prevent transmission of AMR infections including hand hygiene, standard and transmission-based precautions. Attitudes towards AMR were positive, with 84.2% pre intervention and 84.8% of HCW post intervention expressing their willingness to change their work environment to assist with AMR prevention. Perceived readiness to address the problem showed mixed results. Improvements in laboratory AMR surveillance data availability were noted (29.4–52.4%, p < 0001). Modest improvement in the hospital’s capacity for outbreak response (44–51.9%, p = 0.01), and treatment of AMR infections (38.9–44.4%, p = 0.01) was reported.ConclusionsOur data revealed high levels of staff awareness and knowledge about AMR and IPC. However, readiness for outbreak response and treatment of critical AMR infections requires more attention. Improving AMR prevention and containment in CWMH will likely require sustained and multisectoral interventions with strong administrative commitment.

Food safety profile of university food handlers in Bangladesh: A multicenter cross-sectional study

The current study aimed to explore the food safety knowledge, attitudes, and practices of university food handlers in Bangladesh. To achieve this goal, a cross-sectional study was formulated to be carried out among food handlers at different public universities. Data collection was conducted through face-to-face interviews utilizing a structured questionnaire. A total of 788 food handlers participated in the study and were considered for performing all the statistical analyses (descriptive statistics, MannWhitney U test, KruskalWallis H test, multiple logistic regression, and Spearman rankorder correlation). According to the study findings, almost 20.7 % of food handlers lacked formal education, and only 22.8 % had participated in food safety training. Approximately 31.5 % and 28.4 % of the food handlers had good knowledge and good practices, respectively. The majority of the food handlers had poor knowledge about foodborne diseases and foodborne pathogens. Most food handlers had poor hand hygiene practices. Almost all food handlers did not wear caps, gloves, aprons, or masks while handling food. However, despite of having poor knowledge and practices, food handlers (69.8 %) had comparatively good attitudes toward food safety practices, which indicates that adequate support and motivation from food safety authorities can significantly improve preventive practices among them. Therefore, it is recommended that food safety authorities accelerate their activities and arrange hand-based training and educational programs for food handlers to enhance food safety knowledge and practices.

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.

ANALYSIS OF THE INCIDENCE OF DIARRHEA IN TODDLERS 0-59 MONTHS IN COMMUNITY HEALTH CENTERS

Diarrhea is one of the major health problems in children under five in many countries. Diarrhea can cause dehydration, impaired growth, and even death in children under five if not treated appropriately. Puskesmas areas are often the center of public health services, and understanding the incidence of diarrhea in children under five in these areas is important for developing effective prevention and control strategies. The research design is crossectional which aims to analyze the incidence of diarrhea in toddlers 0-59 months. Independent variables in this study are parental education, nutritional status, hand washing habits before feeding, exclusive breastfeeding, clean water sources, and family latrines. While the dependent variable is the incidence of diarrhea. The sampling technique was proportional random sampling. Proportional random sampling. Sample calculation using the lemeshow formula obtained a total of 90 with an anticipated dropout of 10% so that the sample involved in this study was 99. The analysis used was univariate, bivariate, and multivariate. The results of the study reported that there was a relationship between parental education, nutritional status, hand washing habits, exclusive breastfeeding, clean water sources, and latrines on the incidence of diarrhea in toddlers 0-59 months in the Jayapura Health Center Area, East Ogan Komering Ulu Regency in 2024. The most dominant variable associated is the family latrine variable. This research is recommended to further strengthen the role of posyandu and the role of cadres as a form of community mobilization so that the ODF village declaration so that PHBS runs and the incidence of diarrhea in toddlers can be overcome

Investigating the Relationship between Awareness, Beliefs, and Performance of Operating Room Students in Hand Hygiene with Analysis of Microbial Flora on Hands during the COVID-19 Pandemic

BackgroundHand hygiene compliance among hospital staff has always been recognized as an effective method in controlling and reducing hospital-acquired infections. Since the outbreak of the COVID-19 pandemic, hand hygiene has emerged as one of the effective preventive measures against this disease, leading to increased awareness and concerns. This study aims to examine the awareness, beliefs, and practices of operating room students regarding hand hygiene, by analyzing the microbial flora on their hands during the COVID-19 pandemic. The objective is to assess the level of hand hygiene compliance among students, who will be future hospital employees. AimThis study aimed to investigate the correlation between the level of awareness, belief, and performance of operating room students regarding hand hygiene with the analysis of microbial hand flora during the COVID-19 pandemic. The purpose was to examine the compliance with hand hygiene among students, who will be future hospital employees, during this pandemic. MethodologyThe present study included a sample of 92 students majoring in Operating Room who were enrolled in the research through a census. The data collection tool consisted of a questionnaire to assess the students' awareness, beliefs, and performance regarding hand hygiene and analysis of microbial flora on hands. Standard culture media including Blood Agar, Brilliant Green Agar, and Eosin Methylene Blue were used for isolating microorganisms. Microorganism identification was performed using biochemical tests. ResultsThe results of this study indicate that out of the participants, 65 were girls and 27 were boys with an average age of 21.9±2.3 years. The mean scores for awareness, belief, and performance were 8.9, 72.3, and 64.2, respectively. Analysis of microbiological flora also revealed that the highest growth microorganisms were epidermidis bacteria (26.6%), coagulase-negative staphylococci bacteria (22.9%), and streptococcus bacteria (21.2%). Discussion and ConclusionBased on the results of this study, operating room students have shown a high level of awareness, belief, and performance during the COVID-19 pandemic. Furthermore, the minimal growth of bacteria in the conducted culture samples confirms this finding. Due to the limited availability of studies, it is recommended that further research be conducted in this area.

The Effect of Simulation-Based Training on the Hand Hygiene Knowledge and Practices of Palliative Caregivers:A Double-Blind, Randomized, Controlled Single-Center Study.

This study aimed to investigate the effect of simulation-based training on hand hygiene knowledge and practices among palliative caregivers. The study was conducted with 60 caregivers in a palliative care clinic between December 2022 and September 2023. The participants were divided into two groups by simple randomization. The intervention and control groups received the same hand hygiene theoretical education and demonstration. The intervention group also received additional simulation-based hand hygiene practices recommended by the World Health Organization. A pretest-posttest design was used to assess hand hygiene knowledge and practices. Data were collected with personal information, hand hygiene knowledge, and hand hygiene practice forms. Analysis of covariance was performed to compare posttest scores between the groups. Simulation-based hand hygiene training programs offer an effective and feasible strategy to improve the hand hygiene knowledge and practices of caregivers. It should be integrated into clinical areas to increase palliative caregivers' hand hygiene knowledge and practices. Evidence-based practices can be improved by increasing randomized controlled studies on the effectiveness of simulation-based hand hygiene training for caregivers. Trial Registration: The study was registered at ClinicalTrials.gov with registration number NCT05848596.

Integration of an electronic hand hygiene auditing system with electronic health records using machine learning to predict hospital-acquired infection in a health care setting

Hospital-acquired infections (HAIs) increase morbidity, mortality, and healthcare costs. Effective hand hygiene (HH) is crucial for prevention, but achieving high compliance remains challenge. This study explores using machine learning to integrate an electronic HH auditing system with electronic health records to predict HAIs. A retrospective cohort study was conducted at a Brazilian hospital during 2017-2020. HH compliance was recorded electronically, and patient data were collected from electronic health records. The primary outcomes were HAIs per CDC/NHSN surveillance definitions. Machine learning algorithms, balanced with Random Over Sampling Examples (ROSE), were utilized for predictive modeling, including generalized linear models (GLM); generalized additive models for location, scale, and shape (GAMLSS); random forest; support vector machine; and extreme gradient boosting (XGboost). 125 of 6,253 patients (2%) developed HAIs and 920,489 HH opportunities (49.3% compliance) were analyzed. A direct correlation between HH compliance and HAIs was observed. The GLM algorithm with ROSE demonstrated superior performance, with 84.2% sensitivity, 82.9% specificity, and a 93% AUC. Integrating electronic HH auditing systems with electronic health records and using machine learning models can enhance infection control surveillance and predict patient outcomes. Further research is needed to validate these findings and integrate them into clinical practice.

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.

Application of PDCA in improving hand hygiene compliance and nosocomial infection quality in orthopedics†

Abstract Objective To explore the effect of the Plan-Do-Check-Action (PDCA) cycle on hand hygiene and nosocomial infection quality of orthopedic medical staff. Methods The whole year of 2021 was selected to monitor the quality of hand hygiene and hospitalization. Follow-up monitoring and real-time recording during the period of morning shift and medical operation concentration time, and compare the compliance of hand hygiene before and after implementation, and evaluate the quality of nosocomial infection. Results The hand hygiene compliance of doctors and nurses in stage P was 82%. The compliance of medical staff in stage D was 93%. The compliance of stage C was 94% and that of stage A was 95%. The quality score of hospital self-examination nosocomial infection was also significantly increased. Conclusions The PDCA management cycle can effectively improve the compliance of hand hygiene and the nosocomial infection quality, which is worthy of circulatory application in orthopedic nosocomial infection quality control, especially improving the quality of hand hygiene.

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.