Flawed self‐assessment in hand hygiene: A major contributor to infections in clinical practice?

Kelčíková, Simona; Mazúchová, Lucia; Bielena, Lubica; Filová, Lenka

doi:10.1111/jocn.14823

Cited by 14 publications

(22 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, this latter association may have been artificially increased by social desirability bias and thus does not represent true clinical adherence, as has been previously reported for other IPC measures such as hand hygiene. 24 Finally, the reported use of respirators (FFP2/N95 masks) showed a protective effect with lower seropositivity. This observation might reflect either true protection or residual confounding (eg, higher general adherence to IPC recommendations), which needs to be elucidated in welldesigned clinical trials.…”

Section: Discussionmentioning

confidence: 94%

Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroconversion and occupational exposure of employees at a Swiss university hospital: A large longitudinal cohort study

Martischang

Iten

Arm

et al. 2021

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

Background The dynamics of coronavirus disease 2019 (COVID-19) seroconversion of hospital employees are understudied. Our aim was to measure the proportion of seroconverted employees and evaluate risk factors for seroconversion. Methods This prospective cohort study recruited Geneva University Hospitals employees sampled 3 times every 3 weeks from March 30 to June 12, 2020. We measured the proportion of seroconverted employees, and determined prevalence ratios of risk factors for seroconversion using mixed-effects multivariable Poisson regression models. Findings Overall, 3’421 participants (29% of all employees) were included with 92% follow-up. The proportion of seroconverted employees increased from 4·4% [95%CI, 3·7-5·1] at baseline to 8·5% [95%CI, 7·6-9·5] at the last visit. The proportions of seroconverted employees working in COVID-19 (32·3%) and non COVID-19 geriatrics and rehabilitation (G&R) wards (12·3%) were higher compared to office workers (4·9%) at the last visit. Only nursing assistants had a significantly higher risk of seroconversion when compared to office workers (11·7% vs 4·9%, p = 0·006). Significant risk factors for seroconversion included use of public transportation (adjusted prevalence ratio, 1·59 [95%CI 1·25-2·03]), community exposure to SARS-CoV-2 (2·80 [95%CI 2·22-3·54]), working in a ward with a nosocomial COVID outbreak (2·93 [95%CI 2·27-3·79]), and working in COVID-19 (3·47 [95%CI 2·45-4·91]) or non-COVID-19 G&R wards (1·96 [95%CI 1·46-2·63]). An association was observed between reported use of respirators and lower risk of seroconversion (0·73 [95%CI 0·55-0·96]). Interpretation Additional efforts are needed to protect employees in elderly care wards. There is an urgent need for randomized trials on the protective effect of respirators.

show abstract

Section: Discussionmentioning

confidence: 94%

Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroconversion and occupational exposure of employees at a Swiss university hospital: A large longitudinal cohort study

Martischang

Iten

Arm

et al. 2021

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…Self-reported hand hygiene behaviour was higher than observed data in most studies (n=11). The greatest differences were 31% self-reported versus 6% observed hand hygiene in the general public in Peru 80 , and 67% self-reported versus 15% observed hand hygiene in healthcare workers in a large hospital in Vietnam 72 . In the only study that examined it, face covering wearing was self-reported at 25% but observed at 1% in emergency department personnel at a Minnesota public teaching hospital 67 .…”

Section: Resultsmentioning

confidence: 92%

“…Of 18 studies investigating other infectious diseases, most studies (n=15) looked at hand hygiene in a healthcare worker population 63, 64, 66, 68–77, 79, 80 , while two studied it in the general public 65, 78 . One studied face covering use in healthcare workers 67 .…”

Section: Resultsmentioning

confidence: 99%

A systematic review of observational methods used to quantify personal protective behaviours among members of the public during the COVID-19 pandemic, and the concordance between observational and self-report measures in infectious disease health protection

Davies

Mowbray

Martin

et al. 2021

Preprint

View full text Add to dashboard Cite

Objectives: To assess the quantity and quality of studies using an observational measure of behaviour during the COVID-19 pandemic, and to narratively describe the association between self-report and observational data for behaviours relevant to controlling an infectious disease outbreak. Design: Systematic review and narrative synthesis of observational studies. Data sources: We searched Medline, Embase, PsychInfo, Publons, Scopus and the Public Health England behavioural science LitRep database from inception to 17th September 2021 for relevant studies. Study selection: We included studies which collected observational data of at least one of three health protective behaviours (hand hygiene, face covering use and maintaining physical distance from others (social distancing) during the COVID-19 pandemic. Studies where observational data were compared to self-report data in relation to any infectious disease were also included. Data extraction and synthesis: We evaluated the quality of studies using the NIH quality assessment scale for observational studies, extracted data on sample size, setting and adherence to health protective behaviours, and synthesized results narratively. Results: Of 27,279 published papers on COVID-19 relevant health protective behaviours that included one or more terms relating to hand hygiene, face covering and social distancing, we identified 48 studies that included an objective observational measure. Of these, 35 assessed face covering use, 17 assessed hand hygiene behaviour and seven assessed physical distancing. The general quality of these studies was good. When expanding the search to all infectious diseases, we included 21 studies that compared observational versus self-report data. These almost exclusively studied hand hygiene. The difference in outcomes was striking, with self-report over-estimating observed adherence by up to a factor of five in some settings. In only four papers did self-report match observational data in any domains. Conclusions: Despite their importance in controlling the pandemic, we found remarkably few studies assessing protective behaviours by observation, rather than self-report, though these studies tended to be of reasonably good quality. Observed adherence tends to be substantially lower than estimates obtained via self-report. Accurate assessment of levels of personal protective behaviour, and evaluation of interventions to increase this, would benefit from the use of observational methods.

show abstract

“…WHO and HIPAC guidelines reported very low HH compliance among HCWs (7). In 2010, Erasmus et al reported average compliance values of around 40% (19) which started to improve after WHO's "Clean care is safer care" initiative, but the rate of HH adherence and knowledge varies significantly between countries with some specifics for Eastern Europe (13,20,21), often accompanied by flawed self-confidence of HCWs (22). Thus, we cannot rule out the importance of inappropriate examples of HH compliance provided by hospital stuff during the educational process.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of hand hygiene: Is university medical education effective in prevention of hospital-acquired infections?

Kelčíková¹,

Mazúchová²,

Malinovská³

et al. 2021

Cent Eur J Public Health

View full text Add to dashboard Cite

Objective: Hand hygiene (HH) compliance is associated with effective prevention of health care-associated infections (HAI), the topic being very important due to current COVID-19 pandemic. There is a growing debate about the role of educational institutions in the low HH compliance of health workers. This study aimed to assess HH knowledge, self-assessment and attitudes of medical students in relation to provided educational background.Methods: A cross-sectional survey (mixed methods-approach) combined with the curriculum analysis and questionnaires. Quantitative method: a questionnaire of knowledge of HH issues (QK), and a questionnaire of self-assessment and attitudes (SAQ) towards HH. Qualitative method focused on an analysis of content of the curriculum documents.Results: 250 (KQ) and 238 (SAQ) questionnaires were analysed from students of general medicine (n = 262; average age 22.5 years). Belowaverage knowledge of HH and a high self-assessment of knowledge and compliance with HH was reported by 72.2% and 76.0% of students, respectively. Significant differences in knowledge and self-assessment of HH were found among study years and gender. The content analysis has revealed gaps in HH-related information in general medicine educational programme.Conclusions: It is highly expected that there might be some association between low HH knowledge level, false self-assessment and educational programme in medical students.

show abstract

Flawed self‐assessment in hand hygiene: A major contributor to infections in clinical practice?

Cited by 14 publications

References 48 publications

Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroconversion and occupational exposure of employees at a Swiss university hospital: A large longitudinal cohort study

Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroconversion and occupational exposure of employees at a Swiss university hospital: A large longitudinal cohort study

A systematic review of observational methods used to quantify personal protective behaviours among members of the public during the COVID-19 pandemic, and the concordance between observational and self-report measures in infectious disease health protection

Evaluation of hand hygiene: Is university medical education effective in prevention of hospital-acquired infections?

Contact Info

Product

Resources

About