Purpose Limited research has been completed relating to the knowledge, attitudes and practices (KAP) towards hand hygiene in optometry. The necessity of identifying possible gaps in the cycle of the optometric examination that may have an impact on standard hygiene practices is essential, especially seen in the context of the COVID-19 pandemic. The purpose of the study was to determine if optometry students’ KAP towards hand hygiene changed pre- and peri-COVID-19 to minimize the risk of possible infection it may have for their patients, family, and themselves. Patients and Methods A cross-sectional purposeful sample study was completed among optometry students at a training institution in Johannesburg, South Africa, pre- (2019) and peri-COVID-19 (2022). The WHO hand hygiene knowledge and perception questionnaires for health care workers were adapted and used in the current study. Statistical analyses were performed to test for significant changes between the two groups. Results There was a significant change (p < 0.01) in the use of alcohol-based hand rub (ABHR) in 2022 (87.2%) compared to 2019 (46.5%), although only 41% of students peri-COVID-19 (2022), were aware that a minimum of 20 seconds is required to effectively clean hands. Students, both pre-COVID-19 (63.8%) and peri-COVID-19 (81.8%) perceived performing a hand hygiene regime during an optometric examination to be problematic. A significant peri-COVID-19 (2022) change in perception (p < 0.01) regarding the importance of completing required hand hygiene practices in front of a patient during examination was seen. Conclusion The COVID-19 pandemic provided a unique opportunity to research a possible change in KAP towards hand hygiene practices in optometry students that have not been investigated before. Students were more aware of the impact of hand hygiene practices and the perception thereof, especially by patients and fellow students during the peri-COVID-19 (2022) period. An important finding was the difficulty that students experienced to perform a hand hygiene regime during an optometric examination.

Background The link between hand and surface hygiene and the spread of disease has been reported by various studies and understanding the appropriate use of hand hygiene is important in healthcare. The World Health Organization (WHO) introduced the “My Five Moments for Hand Hygiene” model to educate healthcare workers about the importance of hand hygiene to stop the spread of disease. Objective The objectives of this paper were to determine if the WHO Hand Hygiene Observation Form could be used to monitor for hand and personal hygiene practices of Optometry students, and what their actual hygiene practices are in an Optometry training facility in South Africa. Methods This cross-sectional study was performed at an Optometry training facility in South Africa using third (n=32) and fourth year (n=39) students. The Hand Hygiene Knowledge Questionnaire for Health Care Workers by the WHO was used to determine their knowledge regarding hand hygiene. After completing the questionnaire, participants were observed in the clinic while consulting patients to determine the hand and surface hygiene practices they apply. Results The WHO hand hygiene observation rubric was not appropriate to evaluate hand and surface hygiene in Optometry facilities. The adapted observation rubric created was a better tool to evaluate student hygiene practices and was able to record which hand or surface hygiene were missed when presented with such opportunities. Although 90.1% of the students knew that germs could be transferred to the patients via hands, only 46.5% routinely used an alcohol-based hand sanitizer. Conclusion This observation rubric developed during this study can assist in creating awareness with students about their own hand and surface hygiene deficiencies when interacting with patients.

Background Endotracheal intubation by direct laryngoscopy is a mainstay of advanced airway management performed both in the prehospital environment and in the Emergency Department. Many factors may affect the quality of view during direct laryngoscopy, one of them being the visual acuity (VA) of the intubator under these demanding conditions. While some individual variation in VA is to be expected in younger populations, VA naturally deteriorates in older populations particularly beyond the age of 40 years. This study aimed to describe VA in a younger ( n =19) and an older (≥40 years of age, n =20) cohort of intubators at baseline and during simulated adult laryngoscopy, and to compare VA between these two age cohorts. Methods A baseline near VA test was done using a Sloan Early Treatment Diabetic Retinopathy Study (EDTRS) near vision chart at 40 cm under ambient indoor light. Participants in both age cohorts were then requested to perform laryngoscopy using an airway simulator at 40 cm viewing distance and again at a viewing distance of their choice. Both binocular and monocular VA were tested using a near VA chart placed anterior to the vocal cords of the airway trainer. VA was quantified using the logarithm of the minimum angle of resolution (logMAR). Differences in VA between age cohorts were assessed using independent samples t -tests and differences within age cohorts were assessed using paired samples t -tests. Results Binocular and monocular near VA was significantly reduced in the older cohort compared to the younger cohort at baseline (both eyes −0.129 logMAR; p = 0.04, right eye −0.147 logMAR; p = 0.005, left eye −0.197 logMAR; p = 0.002). Within each age cohort VA was significantly reduced during laryngoscopy at a fixed viewing distance (younger; both eyes −0.111 logMAR; p < 0.001, right eye −0.095 logMAR; p < 0.001, left eye −0.105 logMAR; p < 0.001; older; both eyes −0,08 logMAR; p < 0.001, right eye −0.110 logMAR; p < 0.001, left eye −0.065 logMAR; p = 0.01) but this was improved by reducing viewing distance. Conclusion Increased age was associated with a significant reduction in VA at baseline and during laryngoscopy, which can be partially compensated for by adjusting viewing distance. Although it is currently unknown to what extent this age-related reduction of VA might negatively affect time to place an endotracheal tube or success of placement under direct vision, older intubators should be aware of this effect and consider specialized corrective eyewear in order to maintain an adequate level of VA.