Compliance Of Healthcare Workers Research Articles

Monitoring hand hygiene with commercial gas sensors: A pattern recognition approach

Insufficient hand hygiene compliance of Health care workers is a widespread problem in medicine leading to several preventable infections each year. Hence, World Health Organization (WHO) presumes, that up to 1 in 10 patients acquires a Health care associated infection (HCAI) while receiving treatment in health care facilities. Apart from hand hygiene adherence and compliance, a correct hand disinfection technique regarding the amount of hand rub and exposure time is crucial for hand hygiene efficacy. Since alcohol-based hand rub is prevalent in the medical sector, the present study presents a new method for anonymous, electronic hand hygiene monitoring with commercial Ethanol gas sensors. In contrast to previous attempts of electronic monitoring, which mostly merely count the amount of hand hygiene actions, the present approach exploits different algorithms of Machine Learning to assess and categorize the hand disinfection technique into correct and incorrect. To demonstrate functionality of the mentioned approach, labeled hand disinfection data was collected in a pilot study over the period of one year with two different sensor setups. In detail, on the one hand a commercial portable gas sensor tag is used, which can be directly attached to the surgical gown. On the other hand, the performance of several commercial gas sensors is investigated, which are stationarily mounted next to the hand rub dispenser station. The present study follows three subgoals: Firstly, suitability of the stationary vs. portable setup shall be assessed. Secondly, the adequacy of different commercial gas sensor types is evaluated and thirdly the performance of possible algorithms for time series classification of the given sensor response is investigated, i.e. Support Vector Machines (SVM) as well as different Deep Learning algorithms, such as Multilayer Perceptron (MLP), Fully Convolutional Neural Networks (FCN) and a Bidirectional Long-Short-Term Memory network (Bi-LSTM). It could be found that the stationary setup is significantly superior compared to the portable setup. For most of the sensors within this stationary setup an accuracy score between 85% and 87% could be obtained for classification of correctly and incorrectly performed hand disinfections.

Compliance withsafety measures andrisk of COVID-19 transmission among healthcare workers.

Aim:This study aimed to determine the compliance of healthcare workers (HCWs) with the hospital safety measures and the prevalence of hospital-acquired COVID-19 infection among them.Methodology:HCWs at King Abdullah University Hospital (KAUH) assigned for COVID-19 patients between 18 March and 10 June 2020 were tested for past infection using total anti-SARS-CoV-2 immunoglobulin assay, demographic data and compliance with safety measures were assessed using a questionnaire.Results:A total of 340 HCWs participated in the study, 260 were close direct care. Three HCWs tested positive for total anti-SARS-CoV-2 immunoglobulin. Close direct care were more compliant with personal protective guidelines than those providing direct care.Conclusion:HCWs compliance with personal protective guidelines might explain the low prevalence of COVID-19 infection in hospital settings.

Compliance of Healthcare Worker's toward Tuberculosis Preventive Measures in Workplace: A Systematic Literature Review.

Despite several guidelines published by the World Health Organization (WHO) and national authorities, there is a general increase in the number of healthcare workers (HCWs) contracting tuberculosis. This review sought to evaluate the compliance of the HCWs toward tuberculosis preventive measures (TPMs) in their workplace. Both electronic databases and manual searches were conducted to retrieve articles regarding the compliance of HCWs in the workplace published from 2010 onwards. Independent reviewers extracted, reviewed, and analyzed the data using the mixed methods appraisal tool (MMAT) 2018, comprising 15 studies, 1572 HCWs, and 249 health facilities. The results showed there was low compliance toward TPMs in the workplace among HCWs and health facilities from mostly high-burden tuberculosis countries. The failure to comply with control measures against tuberculosis was mainly reported at administrative levels, followed by engineering and personnel protective control measures. In addition, low managerial support and negative attitudes of the HCWs influenced the compliance. Further studies are needed to elucidate how to improve the compliance of HCWs toward the preventive measures against tuberculosis in order to reduce the disease burden among HCWs worldwide.

Predictors for Severity of SARS-CoV-2 Infection Among Healthcare Workers.

BackgroundHealthcare workers (HCWs) are still at higher risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections than the general population. Identifying risk factors associated with severe SARS-CoV-2 infections is of paramount importance to protect HCWs and the non-infected patients attending different healthcare facilities.PurposeTo recognize the predictors for severity of SARS-CoV2 infection among HCWs working in either COVID-19 or non-COVID-19 healthcare settings. Also, to assess compliance of HCW to standard precautions of infection control and explore the possible risk factors for SARS-CoV-2 infection among HCWs.MethodsA cross-sectional study was conducted among HCWs with suspected or confirmed SARS-CoV-2 infection, from different Egyptian governorates. They were asked to fill in a web-based self-reporting questionnaire. The questionnaire assessed the demographic and socio-economic characteristics of participants, compliance of HCWs to standard precautions of infection control and COVID-19 presentation.ResultsOur study enrolled 204 HCWs (52.3% physicians). Infection of SARS-CoV-2 was confirmed in 61.3% by RT- PCR; 35.8% were admitted to hospital, and of these, 3.9% were admitted to the intensive care unit. While 30.4% had mild disease, 48.5% had moderate disease, 17.2% had severe disease and 3.9% had critical disease. Regression analysis for variables predicting COVID-19 severity among study healthcare workers showed that associated chronic diseases and management at home were the main independent variables predicting severity of their SARS-COV-2 infection, while the variables age, sex, residence, occupation or drug history of immunosuppressives had no role in severity prediction.ConclusionAssociated chronic diseases and management at home were the main independent variables predicting severity of SARS-COV-2 infection among HCWs. So, HCWs with chronic diseases should not work in COVID-19 designated hospitals, and there should be a screening strategy for their infection with SARS-COV-2. HCWs must not be negligent in adhering to strict precautions of infection control. HCWs infected with SARS-COV-2 must be managed in hospital not at home.

Compliance and barriers to the use of infection prevention and control measures among health care workers during COVID-19 pandemic in Qatar: A national survey.

AimTo assess health care workers' compliance with infection prevention and control measures in different health care sectors in Qatar during COVID‐19 pandemic.BackgroundBeing the first line of defence against COVID‐19 infection, health care workers are particularly at increased risk of getting infected. Compliance with infection prevention and control measures is essential for their safety and the safety of patients.MethodsA web‐based national survey was conducted between November 2020 and January 2021 targeting all health care workers in governmental, semi‐governmental and private health care sectors.ResultsOf 1,757 health care workers, 49.9% were between 30 and 39 years of age; the majority (47.5%) were nurses. Participants reported a significant increase in the median self‐rated compliance scores during the pandemic compared with before it (p < .001). During the pandemic, 49.7% of health care workers were fully compliant with personal protective equipment (PPE) use; 83.1% were fully compliant with hand hygiene. Overall, 44.1% were fully compliant with infection prevention and control measures (PPE and hand hygiene). Nationality, health sector, profession and frequency of interactions with suspected or confirmed COVID‐19 cases were significantly associated with compliance with overall infection prevention and control measures. The most reported barriers were work overload and shortages of PPE and handwashing agents.ConclusionsCompliance of health care workers with infection prevention and control measures needs further improvement.Implications for Nursing ManagementFrequent quality checks, provision of adequate supplies and behaviour change interventions are recommended strategies for hospital and nursing administrators to improve health care workers' compliance.

Sharps injuries prevention among healthcare providers in surgical, medical and pediatric wards of a public hospital in Jimma Zone: a best practice implementation project.

Sharps injuries are a serious public health problem that healthcare providers face and constitute a major risk for the transmission of blood-borne infections. Prevention of sharps injuries in hospitals requires that healthcare providers comply with universal precautions. The aim of this study was to assess and improve the compliance of healthcare providers with protocols based on best available evidence for prevention of sharps injuries in medical, surgical and pediatric wards of the hospital. A three-phase clinical audit was carried out using the online JBI Practical Application of Clinical Evidence System and Getting Research into Practice Program. Six audit criteria based on available evidence were used. Phase 1 of the project was the baseline audit, phase 2 the implementation of the best practice, and phase 3 the follow-up audit. Data were collected through observation, interview and resource inventory. The postintervention compliance report showed maximum improvement in compliance in criterion 1 (sharps containers are not filled above the mark that indicates the bin is full) and criterion 2 (sharps containers are positioned out of the reach of children at a height that enables safe disposal by staff). Between the baseline and postintervention audits, the compliance rate for these criteria improved by more than half (criterion 1) and by nine-fold (criterion 2) (from 38 to 100% and 0 to 93%, respectively). During baseline, two nurses reported experiencing sharps injuries, noting that they think it is not important to report the injury if the patient is negative for HIV, and when they do not know where to report it, regardless. At the postintervention audit no injuries were reported. The best practice recommendations using a clinical audit process was an effective intervention for improving knowledge and compliance of healthcare workers with protocols for the prevention of sharps injuries in low-resource settings.

Mixed methods study evaluating the implementation of the WHO hand hygiene strategy focusing on alcohol based handrub and training among health care workers in Faranah, Guinea.

The most frequent adverse health events in healthcare worldwide are healthcare-associated infection. Despite ongoing implementation of the WHO multimodal Hand Hygiene (HH) Improvement Strategy, healthcare-associated infection rate continues to be twofold higher in low- than in high-income countries. This study focused on continued evaluation of HH compliance and knowledge. The mixed method approach, with inclusion of patients and care-givers, provided insight into challenges and facilitators of the WHO HH Improvement Strategy, and highlighted improvement points. An uncontrolled, before-and-after intervention, mixed methods study in Faranah Regional Hospital was conducted from December 2017 to August 2019. The intervention implemented the WHO HH Strategy including HH training for healthcare workers (HCWs), and the relaunch of the local production of alcohol-based handrub (ABHR). A baseline assessment of HH knowledge, perception and compliance of HCWs was done prior to the intervention and compared to two follow-up assessments. The second follow-up assessment was complemented by a qualitative component. Overall compliance six months post-intervention was 45.1% and significantly higher than baseline but significantly lower than in first follow-up. Knowledge showed similar patterns of improvement and waning. The perception survey demonstrated high appreciation of the intervention, such as local production of ABHR. HCW's were concerned about overconsuming of ABHR, however simultaneous quantitative measurements showed that consumption in fact was 36% of the estimated amount needed for sufficient HH compliance. Potential fields for improvement identified by HCWs to enhance sustainability were permanent ABHR availability, having a dedicated person with ownership over continuous simulation HH trainings including simulations to improve technique. The study shows that the WHO multimodal HH strategy has a positive effect on HCW compliance and knowledge. Improvement points identified by local staff like sensitization on appropriate ABHR amount per HH action should be considered for sustainable HH improvement.

Three-year hand hygiene monitoring and impact of real-time reminders on compliance

Hand hygiene remains both the major strategy and an ongoing challenge for infection control. The main issues in the sustainability of hand hygiene automatic monitoring are healthcare worker (HCW) turnover rates and declining participation. To assess hand hygiene compliance and the impact of real-time reminders over three years. HCW compliance was observed for the use of alcohol-based hand rubs (AHR) on room entry and exit. Linear multi-level mixed models with time autocorrelations were performed to analyse the repeated measurements of daily room compliance and the effect of reminders over eight quarters (24 months). In all, 111 HCWs were observed and 525,576 activities were identified in the database. There was an improvement in compliance both on room entry and exit over two years, and the rooms which had activated reminders had better performance than the rooms which did not have activated reminders. This study showed the benefit of using real-time reminders; even 20% of rooms with an activated reminder improved overall hand hygiene compliance. A randomized real-time reminder setting may be a potential solution in reducing user fatigue and enhancing HCW self-awareness.

Compliance of healthcare workers to the proper use of personal protective equipment during the first wave of COVID-19 pandemic

BackgroundIn limited resource settings, compliance to proper personal protective equipment (PPE) use is challenging. This study aims to characterize the pattern of PPE use among healthcare workers (HCWs) during the first wave of coronavirus diseases-2019 (COVID-19) in Egypt and to determine the factors associated with compliance to the proper use of PPE. MethodsA cross-sectional study was conducted among Egyptian HCWs using an online self-administered questionnaire. Participants were classified as “Compliant” or “Non-compliant” according to their score. ResultsA total of 404 responses were analyzed, with a mean age of 36.6 ± 8.4 years, and 56.4% were females. Non-compliant HCWs represented 53.2% of participants. The majority reported shortage in N95 respirators (91.3%) and practiced extended PPE use (88.1%). Better compliance to proper PPE use was reported: females (51.3%, p = 0.05), Physicians (54.2 %, p = 0.005), medical specialities (34.7 %, p < 0.001), <10 years’ work experience (42.9%, p = 0.05) and working > eight hours/day (71.3%, p < 0.001). The significant predictors for compliance were; receiving prior training on the proper use of PPE (OR: 4.59, CI: 2.22–9.47, p ≤ 0.001), exposure to COVID-19 patients (OR: 2.75, CI: 1.19–6.35, p = 0.02) and performing procedures that pose HCWs at a high risk of exposure to Severe Acute Respiratory Syndrome Coronavirus 2 (OR: 2.21, CI: 1.04–4.71, p = 0.04). The high percentage of non-compliant HCWs turns on a warning signal. Increase the availability of PPE, prioritize their use, provide more focus on training of HCWs and monitor their compliance is highly recommended.

The Effectiveness of Interventions in Improving Hand Hygiene Compliance: A Meta-Analysis and Logic Model.

Background Despite the availability of various guidelines, rules, and strategies, hand hygiene adherence rates among healthcare workers are reported significantly lower than expected. The aim of this meta-analysis is to determine the most effective interventions to improve hand hygiene and to develop a logic model based on the characteristics of the most effective interventions. Methods A literature search was conducted on PubMed, ProQuest, Web of Knowledge, Scopus, Cochrane Library, and ScienceDirect databases up to December 21, 2019, with no time limit. Randomized clinical trials which had designed interventions to improve hand hygiene were reviewed. Data were extracted independently by two authors. All statistical analyses were performed using Comprehensive Meta-Analysis (CMA) software (version 2.0). A random-effects model was used to estimate odds ratios. Results Although 14 studies were initially reviewed, only 12 studies entered the meta-analysis, since they had identified percentage rates of hand hygiene compliance. The most effective intervention (odds ratio 18.4, 95% CI (13.6–24.8)) was a multilevel strategy that influenced the determinants of hand hygiene behavior at individual, interpersonal, and organizational levels. Following this, a theory-driven logic model was mapped out to promote hand hygiene, based on situational analysis. Conclusion This study suggests that designing integrated interventions based on a multilevel socioecological approach has the greatest potential to improve hand hygiene compliance in healthcare workers. The logical model proposed in this study can thus provide a useful guide for designing and conducting future experimental research.

Through Their Eyes: Health Care Worker Compliance With Personal Protective Equipment During the COVID-19 Pandemic.

Personal protective equipment (PPE) plays a critical role in protecting health care workers (HCWs). During the coronavirus disease-2019 (COVID-19) pandemic, shortages of PPE supplies drastically changed the way PPE was obtained and used by HCWs. The objective was to investigate the impact of the COVID-19 pandemic and patient isolation type on PPE compliance. This investigation was a survey of HCWs at a level 1 trauma teaching hospital regarding PPE compliance patterns prior to and during the COVID-19 pandemic. HCWs reported an increase in PPE compliance during the COVID-19 pandemic. Nearly half (48.6%) of respondents reported that isolation type impacted the decision to wear PPE, of which most were likely to forgo PPE with contact precautions. HCWs identified multiple barriers to compliance. The underutilization of PPE with contact precautions suggests that the risk of exposure is interpreted as low, and this could be a future target of education.

Prevalence of Hospital Associated Infections and Health Care Workers Compliance with Hand Hygiene Practices in a Tertiary Hospital in Sokoto, Nigeria

Background: Hospital associated infections (HAIs) remain a significant cause of morbidity and mortality. And despite the simplicity of hand hygiene practice, an important preventive measure that has been proven to reduce the risk of acquiring and transmitting HAIs, Health care workers (HCW) compliance with the recommendations is of serious concern. Aim: The aim of this study was to determine the prevalence of hospital associated infections and HCWs compliance with hand hygiene practice in a tertiary hospital. Methods and material: This was a hospital-based descriptive cross-sectional study among 110 patients on admission selected using universal sampling, and 377 HCWs selected using a multistage sampling technique. Data collected with self-administered questionnaire for HCWs, interviewer-administered proforma for the patients and data extraction sheet for laboratory analysis. Data analyzed for descriptive statistics using SPSS version 20.0. Results: Patients' mean age was 32.8, IQR: 10.5-37.9 years. Majority, 56(50.9%) were females; Hausa/Fulani, 91(82.7%) and 37(33.6%) had only Qur'anic education while only 20(18.2%) had tertiary education. Health care workers' mean age was 31.8 5.3 years. Majority 227(60.2%) are females, and 267(71.8%) of the participants have received training on hospital infection control. Overall prevalence of HAIs was 42.7%, highest in surgical unit. Commonest HAIs being blood stream infections, and the least, Health Care Associated Pneumonia. Most of the infections were due to Staphylococcus aureus, 22(46.8%) and Pseudomonas aeruginosa, 14(29.8%). Highest hand hygiene practice was reported after contact with body fluid and highest non-compliance reported was before touching patient. Hand hygiene compliance rate was 49.6% and main reasons to non-compliance were high work load, lack of running water and soap, and regular use of hand gloves. Conclusions: Prevalence of HAIs was reportedly high, and low hand hygiene compliance and rate despite majority of the HCWs having received training on Hospital infection control. To reduce the prevalence and the associated burden of HAIs, there is need to put in measures to improve compliance to quality hand hygiene practice by health workers.

Hand hygiene compliance of healthcare workers before and during the COVID-19 pandemic: A long-term follow-up study

BackgroundInformation about the long-term effects of hand hygiene (HH) interventions is needed. We aimed to investigate the change in HH compliance (HHC) of healthcare workers (HCWs) once a data-driven feedback intervention was stopped, and to assess if the COVID-19 pandemic influenced the HH behavior. MethodsWe conducted an observational, extension trial in a surgical department between January 2019–December 2020. Doctors (n = 19) and nurses (n = 53) were included and their HHC was measured using an electronic HH monitoring system (EHHMS). We compared the changes in HHC during 3 phases: (1) Intervention (data presentation meetings), (2) Prepandemic follow-up and (3) Follow-up during COVID-19. ResultsThe HHC during phase 1 (intervention), phase 2 (prepandemic follow-up) and phase 3 (follow-up during COVID-19) was 58%, 46%, and 34%, respectively. Comparison analyses revealed that the HHC was significantly lower in the prepandemic follow-up period (46% vs 58%, P < .0001) and in the follow-up period during COVID-19 (34% vs 58%, P < .0001) compared with the intervention period (phase 1). ConclusionsDespite the COVID-19 pandemic, the HHC of the HCWs significantly decreased over time once the data presentation meetings from management stopped. This study demonstrates that HCWs fall back into old HH routines once improvement initiatives are stopped.

Effectiveness of an electronic hand hygiene monitoring system in increasing compliance and reducing healthcare-associated infections

During an interventional study in a nephrology department, we investigated the effect of an electronic hand hygiene monitoring system on the hand hygiene compliance of healthcare workers (N= 99) and hospital-acquired bloodstream infections. The hand hygiene compliance of the doctors and nurses improved significantly during the intervention phase when they received group and individual feedback based on actionable insights from the electronic hand hygiene monitoring system. The improvements in hand hygiene compliance were associated with a significant reduction in the number of hospital-acquired bloodstream infections.

Repurposing the Ladder

Repurposing the Ladder

Implementation of a multimodal infection control strategy in the nursing home

The main cause of morbidity and mortality among residents of nursing homes (NHs) is healthcare-associated infections (HAIs). We conducted infection control intervention by applying the WHO multimodal strategy for one year from January to December 2018 in the one NH in South Korea. Healthcare workers (HCWs) in NH were observed by infection control nurse from February to December 2018. Hand hygiene (HH) compliance according WHO 5 moments and type of HH, glove use were measured as main outcomes. During the intervention period, a total of 1,461 cases were observed. HH compliance among HCWs increased from 12.6% to 55.2% after the intervention. According to WHO 5 moments, HH before touching a patient and after touching a patient saw significant improvements. Further, glove misuse decreased significantly from 45.9% to 25.4%. The multifaceted infection control program in the NH group significantly improved the HH compliance of HCWs.

Personal protective equipment for Health care workers donning for COVID-19 areas: Walking a tight rope between safety and comfort!

Dear Editor, Coronavirus disease-2019 (COVID-19) pandemic has infected more than 180 million cases worldwide. The frontline healthcare workers (HCWs) battling the disease need to don into personal protective equipment (PPE) to protect themselves from the infection.[1] An N95 respirator is a protective mask designed to achieve an efficient filtration (block at least 95% of particles >0.3 μm in size). Its incorrect use could compromise its protective effect and may even increase the risk of infection.[23] This is especially important for anesthesiologists who are frequently involved in aerosol-generating procedures like noninvasive ventilation, tracheal intubation or extubation. The most important consideration for the effectiveness of a mask is its fit on the HCWs face and its filtration efficacy. A tightly fit mask may lead to discomfort, claustrophobia, pressure on the face and difficulty in breathing.[1] Previous studies have observed that the HCW's compliance with use of N95 mask and the recommended PPE is generally poor because the respirators reduce the maximal physical work capacity by increasing the inspiratory resistance, expiratory resistance, and dead space. COVID areas have limited air conditioning and the non-valved masks may become wet with usage earlier due to inability to dissipate humidity. The resistance offered by the non-valved masks during expiration may lead to headache, inability to concentrate, shortness of breath, dizziness, rise in blood pressure, and fatigue due to accumulation of carbon dioxide.[4] This may increase mask handling and increase the risk of infection to the HCW. In addition, non-valved N95 masks may increase the fogging of goggles and face shield and that makes procedures like intubation difficult for HCW especially with a prolonged donning (6–8 h period usually), in the already cumbersome conditions (PPE and aerosol box).[5] The valved variety allows unimpeded exhalation through one-way valve. An exhalation valve in the N95 masks may help to dissipate humidity, heat, and carbon dioxide from the dead space and decrease exhalation resistance. However, an infected person wearing a valved mask may spread the virus to others around him. No previous study has identified the impact of mask type on COVID-19 transmission. A valved N95 mask may be more acceptable for the HCW, but there is a distinct possibility of transmition of the infection to others. This can be minimized by daily screening of the HCWs before coming for duty, maintaining a safe distance from each other and wearing a surgical mask over it. The stress of working in COVID areas with PPE during the present pandemic has already dented the morale of HCWs. We should ensure comfort of the HCWs along with the safety for others. Based on logical thinking a valved mask should be avoided when working in non-COVID or COVID suspect areas. However, in COVID positive areas where prolonged continuous donning in full PPE is required and risk of infection from HCW to others is negligible, valved mask would offer the best balance of breathing comfort and safety to the provider. Centers for disease control and prevention (CDC) also mentions that valve in N95 masks reduces the exhalation resistance and makes it more comfortable to wear without reducing their efficacy in prevention of infection to the HCWs caring for COVID positive patients.[6] Further research could give invaluable insights for clarifying the risks and level of safety associated with the use of either type of devices and in framing appropriate policies regarding the appropriate type of PPE in various circumstances. We would urge the manufacturers to deliberate into mask designs with appropriate certification like 'SITARA' and are universally acceptable to all HCWs in tackling the pandemic of COVID-19. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Prospective surveillance study in a 1,400-bed university hospital: COVID-19 exposure at home was the main risk factor for SARS-CoV-2 point seroprevalence among hospital staff.

The Co‐HCW study is a prospective cohort study among hospital staff, including healthcare workers (HCWs) and administration staff, at the Jena University Hospital (JUH), Germany. The objectives of this study were to assess SARS‐CoV‐2 IgG seroprevalence, individual exposure risk factors and compliance of HCWs to wear personal protective equipment (PPE). After the first nosocomial COVID‐19 outbreak at JUH, mandatory masking was implemented on 20th March 2020. We evaluated point seroprevalence using two IgG detecting immunoassays and issued a questionnaire to assess COVID‐19 exposure, clinical symptoms and compliance to wear PPE. Antibody retesting was offered to participants with a divergent result of both immunoassays 5–10 weeks after the first test. Between 19th May and 19th June 2020, we analysed 660 participants [out of 3,228; 20.4%]. Among them, 212 participants (32.1%) had received a previous COVID‐19 test. Four of them (1.9%) reported a positive test result. After recruitment, 18 participants (2.7%) had SARS‐CoV‐2 antibodies in at least one immunoassay. Overall, 21 participants (3.2%) had any evidence of a past or current SARS‐CoV‐2 infection. Among them, 13 (61.9%) were not aware of direct COVID‐19 exposure and 9 (42.9%) did not report any clinical symptoms. COVID‐19 exposure at home (adjusted OR (aOR) with 95% CI: 47.82 (5.49, 416.62)) was associated with SARS‐CoV‐2 seroprevalence. We observed no evidence for an association between seroprevalence and exposure at work (aOR 0.48 (0.13, 1.70)) or with COVID‐19 risk area according to the working place (aOR for intermediate‐risk vs. high‐risk: 1.97 (0.42, 9.22), aOR for low‐risk versus high‐risk: 2.10 (0.40, 11.06); p = .655). Reported compliance of HCWs to wear PPE differed (p < .001) between working in high‐risk (98.3%) and in intermediate‐risk areas (69.8%). In conclusion, compared to administration staff, we observed no additional risk to acquire SARS‐CoV‐2 infections by patient care, probably due to high compliance to wear PPE.

Health Care Workers Compliance with Preventive Measures for Covid-19 in Intensive Care Units

Background: Healthcare workers are at the forefront of COVID-19 intervention. Unfortunately, due to highly infected patients with novelty of the virus and the unequipped of hospital to deal with the sudden influx of situations. Aim: to describes the health care workers compliance with preventive measures for covid-19 in ICUs. Setting: The study was carried out on intensive care units (trauma=19, chest=15, general =12, post-operative=12 obstetric=22 ICUs). All health care workers received a cumulative training of standard and additional precautions at health care facility. Method: A prospective cross-sectional study design was conducted among 80 HCWs with COVID- 19 infection at Assuit University Hospitals within one year. Two tools were utilized to collect data; Each participant was contacted individually by the researchers; the questionnaire was distributed to the participants. Data were collected using a self-administered, valid, structured questionnaire. Results: The high percent of healthcare workers (82.5%) always use alcohol-based hand rub or soap and water after touching a patient, (70%) follow recommended hand hygiene practices, (91.3%) had cough and 68 (85 %) had sore throat. Conclusion and Recommendations: The incidence of infection increase, while HCWs followed infection prevention and control measures. Thus vaccinate all health care workers are recommended. In addition, high-risk HCWs could be assigned duties away.

Exploring determinants of hand hygiene compliance in LTCFs: a qualitative study using Flottorps\u2019 integrated checklist of determinants of practice

BackgroundElderly residents in long-term care facilities (LTCFs) are vulnerable to healthcare-associated infections. Although hand hygiene is a leading measure for preventing infection, the compliance of healthcare workers is low. The aim of this study is to identify determinants that influence hand hygiene compliance of nursing staff in LTCFs. This information on determinants can eventually be used to develop a tailored implementation strategy for LTCFs.MethodsThis is an explorative, descriptive study using qualitative methods. We performed semi-structured focus group discussions with 31 nurses and nurse assistants from five Dutch LTCFs. Our focus group discussions continued until no new information could be identified from the data. We used Flottorps’ comprehensive checklist for identifying determinants of practice (the TICD checklist) to guide data collection and analysis. The audiotapes were transcribed verbatim and two authors independently analysed the transcripts with Atlas.ti software.ResultsLTCFs for the elderly have setting specific determinants that are decisive in explaining hand hygiene compliance. Most of these determinants are related to the residents with whom nurses build close relationships and for whom they want to create a homelike atmosphere. Residents can complicate the provision of care with unpredictable behaviour, being unwilling to receive care or use shared facilities. Our study also discovered setting-transcending determinants related to knowledge, professional interactions, guidelines, and incentives/resources.ConclusionsNurses in LTCFs are constantly pursuing a balance between working hygienically, responding adequately to acute care needs, and maintaining a homelike environment for their residents. As a result, setting-specific determinants affect hand hygiene compliance, as do the known determinants that are important in other care settings. To improve compliance in LTCFs, interventions should be selected on a theoretical base while linking these determinants to change interventions.Trial registration Registration number 50-53000-98-113, Compliance With Hand Hygiene in Nursing Homes: Go for a Sustainable Effect (CHANGE) on ClinicalTrials.gov. Date of registration 28-6-2016.