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

Abstract

Background :Information 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. Methods :We 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 three phases: 1) Intervention (data presentation meetings), 2) Pre-pandemic follow-up and 3) Follow-up during COVID-19. Source of funding : This study was partly funded by the Danish Ministry of Health (J. no. 1608966). Conflict of interest MBH is working in Konduto ApS which has developed sani nudge TM . The other authors declare that they have no competing interests. All authors have approved the final article. Results : The HHC during phase 1 (intervention), phase 2 (pre-pandemic 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 pre-pandemic 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). Conclusions : Despite 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.

Hand hygiene compliance among healthcare workers before and during the COVID-19 pandemic

“…This study's findings are in line with another Danish study comparing hand hygiene compliance before and during COVID-19. Stangerup et al, using the same electronic hand hygiene monitoring system, showed that hand hygiene compliance was lower during the COVID-19 pandemic (from October 2020 to December 2020) than during a before-COVID-19 study period (from January 2019 to April 2019); 34% versus 58% 16 . However, the before-COVID-19 study period was a nudging intervention, which might have affected the results.…”

Impact of COVID-19 on an infection prevention and control program, Iowa 2020-2021

“…Improper use of PPE (eg, improper use of gloves due to the fear of contamination), and decrease hand hygiene compliance among HCPs potentially increased the risk of transmission of specific pathogens. 22 , 23 , 24 An increased rate of blood culture contamination during the pandemic may contribute to increased CLABSI rates. 25 …”

Reducing broad-spectrum antibiotic use in intensive care unit between first and second waves of COVID-19 did not adversely affect mortality

“…Once continued glove use was no longer recommended, this embedded practice was difficult to change, and reduced hand hygiene contributed to the risk of transmission. Others have found a decline in hand hygiene compliance during this time [ 23 ].…”