Is it possible to achieve 100 percent hand hygiene compliance during the coronavirus disease 2019 (COVID-19) pandemic?

Wong, Shuk-Ching; AuYeung, C H-Y; Lam, Grace Kee See; Leung, EVAN; Chan, Vernon; Yuen, KY; Cheng, Vincent Chi-Chung

doi:10.1016/j.jhin.2020.05.016

Cited by 49 publications

(48 citation statements)

References 7 publications

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“…29 Therefore, enforcement of hand hygiene in healthcare workers and patients remains the cornerstone of infection control, [24][25][26] especially during the COVID-19 pandemic. 30 Correct wearing of a surgical mask, diligent practice of hand hygiene, and thorough environmental disinfection should be sufficient for the prevention of COVID-19 in the hospital setting, except during aerosol-generating procedures or when high numbers of COVID-19 patients are concentrated in a cohort ward. This study has several limitations.…”

Section: Discussionmentioning

confidence: 99%

Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19)

Cheng

Wong

Chan

et al. 2020

Infect. Control Hosp. Epidemiol.

177

162

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Background: The role of severe respiratory coronavirus virus 2 (SARS-CoV-2)–laden aerosols in the transmission of coronavirus disease 2019 (COVID-19) remains uncertain. Discordant findings of SARS-CoV-2 RNA in air samples were noted in early reports. Methods: Sampling of air close to 6 asymptomatic and symptomatic COVID-19 patients with and without surgical masks was performed with sampling devices using sterile gelatin filters. Frequently touched environmental surfaces near 21 patients were swabbed before daily environmental disinfection. The correlation between the viral loads of patients’ clinical samples and environmental samples was analyzed. Results: All air samples were negative for SARS-CoV-2 RNA in the 6 patients singly isolated inside airborne infection isolation rooms (AIIRs) with 12 air changes per hour. Of 377 environmental samples near 21 patients, 19 (5.0%) were positive by reverse-transcription polymerase chain reaction (RT-PCR) assay, with a median viral load of 9.2 × 102 copies/mL (range, 1.1 × 102 to 9.4 × 104 copies/mL). The contamination rate was highest on patients’ mobile phones (6 of 77, 7.8%), followed by bed rails (4 of 74, 5.4%) and toilet door handles (4 of 76, 5.3%). We detected a significant correlation between viral load ranges in clinical samples and positivity rate of environmental samples (P < .001). Conclusion: SARS-CoV-2 RNA was not detectable by air samplers, which suggests that the airborne route is not the predominant mode of transmission of SARS-CoV-2. Wearing a surgical mask, appropriate hand hygiene, and thorough environmental disinfection are sufficient infection control measures for COVID-19 patients isolated singly in AIIRs. However, this conclusion may not apply during aerosol-generating procedures or in cohort wards with large numbers of COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19)

Cheng

Wong

Chan

et al. 2020

Infect. Control Hosp. Epidemiol.

177

162

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“…Four recent studies found that HCW hand hygiene compliance improved during the early pandemic (first quarter of 2020); however, three of these studies were observed by audit without comparing with any remarkable events in national COVID-19 control [ [17] , [18] , [19] , [20] ]. One study which was based on an automated monitoring system obtained a similar result to ours.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 outbreak and healthcare worker behavioural change toward hand hygiene practices

Huang

Armando

Dufau

et al. 2021

Journal of Hospital Infection

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Background The coronavirus disease (COVID-19) pandemic has affected healthcare workers (HCW) in their clinical practice. HCW were challenged with new guidelines and practices to protect themselves from occupational risks. We wished to observe if hand hygiene behavior by real-time measurement was related to the dynamic of the epidemic, and the type of patient being cared for in France. Methods This study used an automated hand hygiene recording system to measure HCW hand hygiene on entry to and exit from patient rooms throughout the COVID-19 pandemic. We analyzed the correlation between hand hygiene compliance and COVID-19 epidemiological data. Analysis of variance was performed to compare compliance rate during the different periods of the epidemic. Findings HCW hand hygiene rate on room entry decreased over time; on room exit, it increased by 13.73% during the first wave of COVID-19, decreased by 9.87% during the post-lockdown period, then rebounded by 2.82% during the second wave of the epidemic. Hand hygiene during patient care and hand hygiene on room exit had a positive relationship with the local COVID-19 epidemic; conversely, hand hygiene on room entry did not depend on the trend of the epidemic, nor on nursing of COVID-19 patients, and it decreased over time. Conclusion HCW modified their behaviors to face the risk propensity of the pandemic. However, to improve the poor compliance at room entry, reducing confusion between the hand hygiene recommendation and glove recommendation may be necessary; disinfection of gloving hands might solve this issue.

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“…This factor is the reason we have highly promoted our institutionally designed sixth moment, "hand hygiene before touching your mucous membrane," together with the practice of WHO Five Moments for Hand Hygiene. 7,8 Compliance with universal masking was monitored between May and June 2020, 4 months after the activation of emergency response level when universal masking was implemented in our hospitals. Compliance with universal masking among HCWs remains 100%, suggesting that the practice of universal masking among HCWs is sustainable in the COVID-19 era.…”

Section: Discussionmentioning

confidence: 99%

Absence of nosocomial influenza and respiratory syncytial virus infection in the coronavirus disease 2019 (COVID-19) era: Implication of universal masking in hospitals

Wong

Lam

Auyeung

et al. 2020

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

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Is it possible to achieve 100 percent hand hygiene compliance during the coronavirus disease 2019 (COVID-19) pandemic?

Cited by 49 publications

References 7 publications

Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19)

Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19)

COVID-19 outbreak and healthcare worker behavioural change toward hand hygiene practices

Absence of nosocomial influenza and respiratory syncytial virus infection in the coronavirus disease 2019 (COVID-19) era: Implication of universal masking in hospitals

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