Barriers to hand hygiene compliance in intensive care units during the COVID-19 pandemic: A qualitative study

Abstract

BackgroundThe practice of hand washing is an effective way to prevent contamination and disease transmission. Following the COVID-19 pandemic, hand washing has become increasingly important. Therefore, this qualitative study aimed to understand barriers to hand hygiene compliance among healthcare workers during the COVID-19 pandemic.Materials and methodsTwenty-five healthcare workers from intensive care units were sampled using purposive sampling in a qualitative content analysis study. Data were collected through a semi-structured interview and field notes. Based on the Lundman and Graneheim approach, the data were analyzed. COREQ checklist was used to report the research.ResultsAccording to the findings, there are three main categories of barriers to hand hygiene practice: barriers related to individuals (including two subcategories of lack of knowledge of healthcare workers and healthcare workers' improper attitude), barriers related to management (including two subcategories of wrong behavioral patterns and unsuitable training and planning), and barriers related to organizations (including four subcategories of heavy workloads, improperly designed wards, a lack of equipment, and lack of quality equipment).ConclusionsThis research indicates that hand washing practice increased during the COVID-19 pandemic. Nevertheless, some barriers persist, resulting in a decline in hand washing compliance among health care workers. This finding can help managers and policymakers remove barriers to hand washing compliance and improve healthcare workers' adherence to hand washing.

Enablers and Barriers to Handwashing and Vaccine Uptake in Kenya, Uganda, and Tanzania in Relation to COVID-19 Prevention and Control: A Systematic Review

“…Regarding barriers to Covid-19 vaccine and handwashing uptake, previous research ndings agree with study ndings. A study to investigate hand hygiene barriers in a teaching hospital's intensive care unit in southeast Iran (12), found out that a lack of quality equipment reduced hand hygiene practices. The study revealed poor quality soap resulting in skin dryness and itching, and a shortage of disinfectants led to minimal hand hygiene compliance.…”

“…The Coronavirus disease 2019 has brought about unprecedented challenges globally, threatening to undo the decades of progress on poverty, health systems and education (1). To date, the pandemic has resulted to more than 6.7 million deaths worldwide, loss of jobs equivalent to 114 million globally and about half of the world's 3.3 billion workforce is at the verge of losing their livelihoods 12 , thus raising many concerns in everyone's, mind especially about how to respond to the pandemic (1).…”

“…A study in Sub-Saharan Africa to investigate the obstacles to hand hygiene practices revealed that to improve hand hygiene practices, it was necessary to offer education on the topic and sustainable solutions to the water shortage, disinfectants, incentives, among other remedies (11). A study to investigate about hand hygiene obstacles in an intensive care unit of a teaching hospital in southeast Iran showed that lack of high-quality equipment decreased hand hygiene habits (12). According to the study, low-quality soap caused skin to become dry and itchy, and a lack of disinfectants resulted in low hand hygiene compliance.…”

Biosafety protection and workflow of clinical microbiology laboratory under COVID-19: A review

“…Master of the correct hand washing method (7-step washing technique) and timing. [54][55][56][57] Step 1 (inside): wash your hands, wet your hands with running water, apply hand sanitizer, keep your palms opposite, and rub your fingers together; Step 2 (outside): wash the back finger seam, rub the palm of your hand and the back of your hand along the finger seam, and exchange your hands; Step 3 (clip): wash the palm side finger seam, the palms are opposite, and the hands cross and rub each other along the finger seam; The fourth step is to bend the fingers on the back and rub the fingers on the other hand; Step 5 (big): wash the thumb, hold the thumb of the other hand in one hand, rotate and rub it, and exchange hands; Step 6 (standing): wash the fingertips, bend the finger joints, close the fingertips to the palm of the other hand, rotate and rub, and exchange hands; Step 7 (wrists): wash wrists and arms, rub wrists and arms, and exchange hands. The rubbing time for each step of the hand washing should be greater than 15 seconds.…”

Behavioral determinants of hand hygiene compliance among nurses in intensive care units in Hai’l, Saudi Arabia

“…Being around highcompliance co-workers (i.e., role models) is a typical example of a positive and valuable social influence (Hoffmann et al, 2020). In Ahmadipour et al (2022), HCWs reported the existence of negative models, such as the influence of experienced nurses or physicians who did not adhere to HH guidelines, as a reason for their noncompliance. Self-efficacy refers to an individual's belief in their ability to succeed in a given situation.…”