Hand Hygiene in Pediatric Emergency Care Unit in a Teaching Hospital in Benin

Introduction: Appropriate hand hygiene reduces healthcare associated infections (HCAI). The present study was an attempt to determine the real knowledge and practices of healthcare professionals of pediatric emergency care unit in Benin. Methods: This was a three-month observational study. First a trained interviewer observed both the premises and the healthcare professionals during their administering treatment, without their knowledge. Second, their level of knowledge about HCAI was examined using a self-administered questionnaire. Finally, bacteria were cultured/measured from their hands before and after hand-washing through swab samples. Outcome: The modes of microorganism transmission were poorly known (21.6%), but knowledge about the 5 moments for hand hygiene was satisfactory (84.1%). Hand hygiene adherence rate was 6.9% in the study population. Simple hand-washing was prevalent (82%). The healthcare professionals did not adhere to the recommended duration for hand-washing. The required hand-washing equipment was inadequate, and alcohol-based handrub dispenser was unavailable. Microorganism isolated from healthcare professionals before hand-washing included Klebsiella pneumonia and Enterobacter Cloacae. After hand-washing, the transient flora decreased. Conclusion: Hand hygiene adherence rate is low in the study population. An immediate action is required to improve observance of hand-washing. This may include: training healthcare professionals, displaying visual behavior reminder posters, providing alcohol-based handrub.

The Influence of Emotions and Behavioral Theories behind Hand Hygiene in COVID-19 Pandemic

Background: Hand hygiene (HH) is essential in preventing healthcare-associated infections, especially during the COVID-19 pandemic, where SARS-CoV2 has shown the ability to survive on surfaces for days. In this study, we explore HH compliance rate and the factors associated with its increase during COVID-19 pandemic. Methods: HH compliance was assessed amongst doctors in Anesthesia and Surgical Intensive Care Unit by direct observation between 2018 and 2021. An anonymous survey was then sent to the doctors to understand factors influencing the observed improvement in HH compliance during the pandemic. Results: Compliance towards the five moments of HH has shown a statistically significant rising trend from a median HH compliance of 60% in 2018, to 70% in 2019 to 94% in 2020. However, HH compliance subsequently declined in the first quarter of 2021 to median of 87%. The follow-up survey had a response rate of 96% (n = 53). 90% of survey participants responded that their HH frequency had increased during the COVID-19 pandemic with 47% stating they were performing HH 11 - 20 times/day. 64% responded that this increased frequency had affected their skin condition. 62% responded that this increased frequency was sustainable even after the pandemic ends. Participants ranked considerations influencing HH compliance. “Prevent transmitting the infection to vulnerable patients” was ranked highest followed by “High infection rate”, “Fear of contracting COVID-19” and lastly, “Public health guidelines”. Conclusions: Despite the absence of new campaigns, HH compliance reached an all-time high. The pandemic has provided opportunity for behavioral change through “reflective” drivers of behavior such as emotions (“Fear”) and knowledge (“High infection rate”). Understanding the motivations behind current increased HH compliance and riding on the increased initial uptake of behavior may help convert HH into a habitual action and not just a reaction to the pandemic.