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1.
Sci Rep ; 11(1): 21654, 2021 11 04.
Article in English | MEDLINE | ID: covidwho-1504870

ABSTRACT

To slow the spread of infectious disease, it is crucial to understand the engagement of protective behavior among individuals. The purpose of this study was to systematically examine individuals' protective behaviors and the associated factors across countries during COVID-19. This causal-comparative study used a self-developed online survey to assess individuals' level of engagement with six protective behaviors. Analysis of variance and McNemar's test were employed for data analysis. Three hundred and eighty-four responses were analyzed. The majority of participants lived in three areas: Taiwan, Japan, and North America. Overall, the participants reported a high level of engagement in protective behaviors. However, engagement levels varied according to several demographic variables. Hand hygiene and cleaning/ventilation are two independent behaviors that differ from almost all other protective behaviors. There is a need to target the population at risk, which demonstrates low compliance. Different strategies are needed to promote specific protective behaviors.


Subject(s)
COVID-19/prevention & control , COVID-19/psychology , Risk Reduction Behavior , Adult , Female , Hand Hygiene/trends , Health Behavior , Humans , Male , Middle Aged , Physical Distancing , SARS-CoV-2/pathogenicity , Surveys and Questionnaires
2.
PLoS One ; 16(10): e0258662, 2021.
Article in English | MEDLINE | ID: covidwho-1496511

ABSTRACT

We aimed to apply the Systems Engineering Initiative for Patient Safety (SEIPS) model to increase effectiveness and sustainability of the World Health Organization's (WHOs) hand hygiene (HH) guidelines within healthcare systems. Our cross-sectional, mixed-methods study took place at Jimma University Medical Center (JUMC), a tertiary care hospital in Jimma, Ethiopia, between November 2018 and August 2020 and consisted of three phases: baseline assessment, intervention, and follow-up assessment. We conducted questionnaires addressing HH knowledge and attitudes, interviews to identify HH barriers and facilitators within the SEIPS framework, and observations at the WHO's 5 moments of HH amongst healthcare workers (HCWs) at JUMC. We then implemented HH interventions based on WHO guidelines and results from our baseline assessment. Follow-up HH observations were conducted months later during the Covid-19 pandemic. 250 HCWs completed questionnaires with an average knowledge score of 61.4% and attitude scores indicating agreement that HH promotes patient safety. Interview participants cited multiple barriers to HH including shortages and location of HH materials, inadequate training, minimal Infection Prevention Control team presence, and high workload. We found an overall baseline HH compliance rate of 9.4% and a follow-up compliance rate of 72.1%. Drastically higher follow-up compared to baseline compliance rates were likely impacted by our HH interventions and Covid-19. HCWs showed motivation for patient safety despite low HH knowledge. Utilizing the SEIPS model helped identify institution-specific barriers that informed targeted interventions beyond WHO guidelines aimed at increasing effectiveness and sustainability of HH efforts.


Subject(s)
Hand Disinfection/methods , Hand Disinfection/trends , Hand Hygiene/methods , Adult , COVID-19/prevention & control , Cross Infection/prevention & control , Cross-Sectional Studies , Ethiopia , Female , Guideline Adherence/statistics & numerical data , Hand Hygiene/trends , Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Humans , Infection Control/methods , Male , Pandemics/prevention & control , SARS-CoV-2/pathogenicity , Surveys and Questionnaires , Tertiary Care Centers
3.
Rev Esp Quimioter ; 34(3): 214-219, 2021 Jun.
Article in Spanish | MEDLINE | ID: covidwho-1390022

ABSTRACT

OBJECTIVE: Proper hand hygiene is the main measure in the prevention and control of infection associated with healthcare. It describes how the pandemic period of 2020 has influenced the evolution of the degree of compliance with hand hygiene practices in health professionals at the Hospital Universitario Insular de Gran Canaria with respect to previous years. METHODS: Descriptive cross-sectional study of direct observation on compliance with the five moments of hand hygiene in the 2018-2020 period. Adherence is described with the frequency distribution of the different moments in which it was indicated. RESULTS: Total adherence has increased from 42.5% in 2018, to 47.6% in 2019, and 59.2% in 2020 (p <0.05). Total adherence was greater in the moments after contact with the patient (67%) than in the moments before contact (48%). The area with the highest adherence was dialysis (83%). There is a greater adherence in open areas than in hospitalization areas (65% vs 56%). Higher adherence was determined in physicians (73%) and nurses (74%), than in nursing assistants (50%) (p<0.05). CONCLUSIONS: In 2020 there was an increase in adherence to hand hygiene compared to previous years. A higher percentage of adherence was determined in physicians and nurses than in nursing assistants. We consider that the current SARS-CoV-2 pandemic has played a relevant role in this increase in adherence.


Subject(s)
COVID-19/epidemiology , Hand Hygiene/trends , Health Personnel , Pandemics , COVID-19/prevention & control , Cross-Sectional Studies , Hand Hygiene/statistics & numerical data , Health Personnel/statistics & numerical data , Health Personnel/trends , Humans , Medical Staff, Hospital/statistics & numerical data , Medical Staff, Hospital/trends , Nursing Assistants/statistics & numerical data , Nursing Assistants/trends , Nursing Staff, Hospital/statistics & numerical data , Nursing Staff, Hospital/trends , Spain , Tertiary Care Centers
4.
Lancet Infect Dis ; 21(8): e209-e221, 2021 08.
Article in English | MEDLINE | ID: covidwho-1331321

ABSTRACT

Health-care-associated infections are the most prevalent adverse events of hospital care, posing a substantial threat to patient safety and burden on society. Hand hygiene with alcohol-based hand rub is the most effective preventive strategy to reduce health-care-associated infections. Over the past two decades, various interventions have been introduced and studied to improve hand hygiene compliance among health-care workers. The global implementation of the WHO multimodal hand hygiene improvement strategy and constant efforts to replace the use of soap and water with alcohol-based hand rub have led to a faster and more efficient hand cleaning method. These strategies have strongly contributed to the success of behaviour change and a subsequent decrease in health-care-associated infections and cross-transmission of multidrug-resistant organisms worldwide. The WHO multimodal behaviour change strategy requires a series of elements including system change as a prerequisite for behaviour, change, education, monitoring and performance feedback, reminders in the workplace, and an institutional safety climate. Successful adoption of the promotion strategy requires adaptation to available resources and sociocultural contexts. This Review focuses on the major advances and challenges in hand hygiene research and practices in the past 20 years and sets out various ways forward for improving this lifesaving action.


Subject(s)
COVID-19/prevention & control , Cross Infection/prevention & control , Hand Hygiene/history , Health Personnel , Publications/statistics & numerical data , Guideline Adherence , Guidelines as Topic , Hand Disinfection/methods , Hand Hygiene/trends , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Infection Control/methods , Research/trends
5.
PLoS One ; 16(5): e0251694, 2021.
Article in English | MEDLINE | ID: covidwho-1225817

ABSTRACT

The main strategy for combatting SARS-CoV-2 infections in 2020 consisted of behavioural regulations including contact reduction, maintaining distance, hand hygiene, and mask wearing. COVID-19-related risk perception and knowledge may influence protective behaviour, and education could be an important determinant. The current study investigated differences by education level in risk perception, knowledge and protective behaviour regarding COVID-19 in Germany, exploring the development of the pandemic over time. The COVID-19 Snapshot Monitoring study is a repeated cross-sectional online survey conducted during the pandemic in Germany from 3 March 2020 (waves 1-28: 27,957 participants aged 18-74). Differences in risk perception, knowledge and protective behaviour according to education level (high versus low) were analysed using linear and logistic regression. Time trends were accounted for by interaction terms for education level and calendar week. Regarding protective behaviour, interaction terms were tested for all risk perception and knowledge variables with education level. The strongest associations with education level were evident for perceived and factual knowledge regarding COVID-19. Moreover, associations were found between low education level and higher perceived severity, and between low education level and lower perceived probability. Highly educated men were more worried about COVID-19 than those with low levels of education. No educational differences were observed for perceived susceptibility or fear. Higher compliance with hand washing was found in highly educated women, and higher compliance with maintaining distance was found in highly educated men. Regarding maintaining distance, the impact of perceived severity differed between education groups. In men, significant moderation effects of education level on the association between factual knowledge and all three protective behaviours were found. During the pandemic, risk perception and protective behaviour varied greatly over time. Overall, differences by education level were relatively small. For risk communication, reaching all population groups irrespective of education level is critical.


Subject(s)
COVID-19/psychology , Health Knowledge, Attitudes, Practice/ethnology , Risk Reduction Behavior , Adult , Aged , Anxiety/epidemiology , Cross-Sectional Studies , Educational Status , Fear/psychology , Female , Germany/epidemiology , Hand Disinfection/trends , Hand Hygiene/methods , Hand Hygiene/trends , Health Risk Behaviors , Humans , Male , Middle Aged , Pandemics/prevention & control , Perception , Risk Assessment/methods , SARS-CoV-2/pathogenicity , Surveys and Questionnaires
6.
J Hosp Infect ; 111: 6-26, 2021 May.
Article in English | MEDLINE | ID: covidwho-1141983

ABSTRACT

BACKGROUND: There is general consensus that hand hygiene is the most effective way to prevent healthcare-associated infections. However, low rates of compliance amongst healthcare workers have been reported globally. The coronavirus disease 2019 pandemic has further emphasized the need for global improvement in hand hygiene compliance by healthcare workers. AIM: This comprehensive systematic review provides an up-to-date compilation of clinical trials, reported between 2014 and 2020, assessing hand hygiene interventions in order to inform healthcare leaders and practitioners regarding approaches to reduce healthcare-associated infections using hand hygiene. METHODS: CINAHL, Cochrane, EMbase, Medline, PubMed and Web of Science databases were searched for clinical trials published between March 2014 and December 2020 on the topic of hand hygiene compliance among healthcare workers. In total, 332 papers were identified from these searches, of which 57 studies met the inclusion criteria. FINDINGS: Forty-five of the 57 studies (79%) included in this review were conducted in Asia, Europe and the USA. The large majority of these clinical trials were conducted in acute care facilities, including hospital wards and intensive care facilities. Nurses represented the largest group of healthcare workers studied (44 studies, 77%), followed by physicians (41 studies, 72%). Thirty-six studies (63%) adopted the World Health Organization's multi-modal framework or a variation of this framework, and many of them recorded hand hygiene opportunities at each of the 'Five Moments'. However, recording of hand hygiene technique was not common. CONCLUSION: Both single intervention and multi-modal hand hygiene strategies can achieve modest-to-moderate improvements in hand hygiene compliance among healthcare workers.


Subject(s)
COVID-19/prevention & control , Cross Infection/prevention & control , Guideline Adherence/trends , Hand Hygiene/standards , Hand Hygiene/trends , Health Personnel/psychology , Health Personnel/statistics & numerical data , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Adult , Female , Forecasting , Guideline Adherence/statistics & numerical data , Hand Hygiene/statistics & numerical data , Humans , Male , Middle Aged , SARS-CoV-2
7.
PLoS One ; 15(12): e0242403, 2020.
Article in English | MEDLINE | ID: covidwho-963802

ABSTRACT

Globally, public health measures like face masks, hand hygiene and maintaining social distancing have been implemented to delay and reduce local transmission of COVID-19. To date there is emerging evidence to provide effectiveness and compliance to intervention measures on COVID-19 due to rapid spread of the disease. We synthesized evidence of community interventions and innovative practices to mitigate COVID-19 as well as previous respiratory outbreak infections which may share some aspects of transmission dynamics with COVID-19. In the study, we systematically searched the literature on community interventions to mitigate COVID-19, SARS (severe acute respiratory syndrome), H1N1 Influenza and MERS (middle east respiratory syndrome) epidemics in PubMed, Google Scholar, World Health Organization (WHO), MEDRXIV and Google from their inception until May 30, 2020 for up-to-date published and grey resources. We screened records, extracted data, and assessed risk of bias in duplicates. We rated the certainty of evidence according to Cochrane methods and the GRADE approach. This study is registered with PROSPERO (CRD42020183064). Of 41,138 papers found, 17 studies met the inclusion criteria in various settings in Low- and Middle-Income Countries (LMICs). One of the papers from LMICs originated from Africa (Madagascar) with the rest from Asia 9 (China 5, Bangladesh 2, Thailand 2); South America 5 (Mexico 3, Peru 2) and Europe 2 (Serbia and Romania). Following five studies on the use of face masks, the risk of contracting SARS and Influenza was reduced OR 0.78 and 95% CI = 0.36-1.67. Equally, six studies on hand hygiene practices reported a reduced risk of contracting SARS and Influenza OR 0.95 and 95% CI = 0.83-1.08. Further two studies that looked at combined use of face masks and hand hygiene interventions showed the effectiveness in controlling the transmission of influenza OR 0.94 and 95% CI = 0.58-1.54. Nine studies on social distancing intervention demonstrated the importance of physical distance through closure of learning institutions on the transmission dynamics of disease. The evidence confirms the use of face masks, good hand hygiene and social distancing as community interventions are effective to control the spread of SARS and influenza in LMICs. However, the effectiveness of community interventions in LMICs should be informed by adherence of the mitigation measures and contextual factors taking into account the best practices. The study has shown gaps in adherence/compliance of the interventions, hence a need for robust intervention studies to better inform the evidence on compliance of the interventions. Nevertheless, this rapid review of currently best available evidence might inform interim guidance on similar respiratory infectious diseases like Covid-19 in Kenya and similar LMIC context.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Early Medical Intervention/methods , Coronavirus Infections/epidemiology , Developing Countries , Disease Outbreaks , Hand Hygiene/trends , Humans , Income , Influenza A Virus, H1N1 Subtype/pathogenicity , Kenya/epidemiology , Masks/trends , Pandemics , Pneumonia, Viral/epidemiology , Public Health , SARS-CoV-2 , Severe Acute Respiratory Syndrome/epidemiology
8.
Am J Infect Control ; 49(1): 30-33, 2021 01.
Article in English | MEDLINE | ID: covidwho-722966

ABSTRACT

BACKGROUND: Achieving high levels of hand hygiene compliance of health care personnel has been an ongoing challenge. The objective of this study was to examine the impact of the COVID-19 pandemic on hand hygiene performance (HHP) rates in acute care hospitals. METHODS: HHP rates were estimated using an automated hand hygiene monitoring system installed in 74 adult inpatient units in 7 hospitals and 10 pediatric inpatient units in 2 children's hospitals. A segmented regression model was used to estimate the trajectory of HHP rates in the 10 weeks leading up to a COVID-19-related milestone event (eg, school closures) and for 10 weeks after. RESULTS: Three effects emerged, all of which were significant at P < .01. Average HHP rates increased from 46% to 56% in the months preceding pandemic-related school closures. This was followed by a 6% upward shift at the time school closures occurred. HHP rates remained over 60% for 4 weeks before declining to 54% at the end of the study period. CONCLUSIONS: Data from an automated hand hygiene monitoring system indicated that HHP shifted in multiple directions during the early stages of the pandemic. We discuss possible reasons why HHP first increased as the pandemic began and then decreased as it progressed.


Subject(s)
COVID-19/epidemiology , Guideline Adherence/trends , Hand Disinfection/trends , Health Personnel , Infection Control/trends , Automation , COVID-19/prevention & control , Hand Disinfection/standards , Hand Hygiene/standards , Hand Hygiene/trends , Hand Sanitizers , Hospitals , Humans , Infection Control/standards , SARS-CoV-2 , Soaps , United States/epidemiology
9.
Oncologist ; 25(6): e936-e945, 2020 06.
Article in English | MEDLINE | ID: covidwho-31492

ABSTRACT

The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread globally since being identified as a public health emergency of major international concern and has now been declared a pandemic by the World Health Organization (WHO). In December 2019, an outbreak of atypical pneumonia, known as COVID-19, was identified in Wuhan, China. The newly identified zoonotic coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is characterized by rapid human-to-human transmission. Many cancer patients frequently visit the hospital for treatment and disease surveillance. They may be immunocompromised due to the underlying malignancy or anticancer therapy and are at higher risk of developing infections. Several factors increase the risk of infection, and cancer patients commonly have multiple risk factors. Cancer patients appear to have an estimated twofold increased risk of contracting SARS-CoV-2 than the general population. With the WHO declaring the novel coronavirus outbreak a pandemic, there is an urgent need to address the impact of such a pandemic on cancer patients. This include changes to resource allocation, clinical care, and the consent process during a pandemic. Currently and due to limited data, there are no international guidelines to address the management of cancer patients in any infectious pandemic. In this review, the potential challenges associated with managing cancer patients during the COVID-19 infection pandemic will be addressed, with suggestions of some practical approaches. IMPLICATIONS FOR PRACTICE: The main management strategies for treating cancer patients during the COVID-19 epidemic include clear communication and education about hand hygiene, infection control measures, high-risk exposure, and the signs and symptoms of COVID-19. Consideration of risk and benefit for active intervention in the cancer population must be individualized. Postponing elective surgery or adjuvant chemotherapy for cancer patients with low risk of progression should be considered on a case-by-case basis. Minimizing outpatient visits can help to mitigate exposure and possible further transmission. Telemedicine may be used to support patients to minimize number of visits and risk of exposure. More research is needed to better understand SARS-CoV-2 virology and epidemiology.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/prevention & control , Medical Oncology/organization & administration , Neoplasms/therapy , Pandemics/prevention & control , Patient Care/standards , Pneumonia, Viral/prevention & control , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Hand Hygiene/organization & administration , Hand Hygiene/trends , Humans , Infection Control/organization & administration , Infection Control/trends , International Cooperation , Intersectoral Collaboration , Medical Oncology/economics , Medical Oncology/standards , Medical Oncology/trends , Patient Care/economics , Patient Care/trends , Patient Education as Topic , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Resource Allocation/economics , Resource Allocation/organization & administration , Resource Allocation/standards , Resource Allocation/trends , SARS-CoV-2 , Telemedicine/economics , Telemedicine/organization & administration , Telemedicine/standards , Telemedicine/trends , World Health Organization
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