Comparison of hand hygiene compliance among healthcare workers in Intensive care units and wards of COVID-19: A large scale multicentric study in India
•This multicentric study is first of its kind to involve COVID care locations from various types of institutions from different zones of India.•Overall data on hand hygiene compliance in various locations across the country provides national bench mark data.•Hand hygiene total adherence rate (HHCAR)...
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| Veröffentlicht in: | American journal of infection control 2023-03, Vol.51 (3), p.304-312 |
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| creator | Dhandapani, Sarumathi Krishnamoorthi, Sivanantham Sundaramurthy, Raja Madigubba, Haritha Sastry, Dr Apurba Sankar Priyadarshi, Dr Ketan Krishnamoorthi, Dr Sivanantham Sundaramurthy, Dr Raja Billoria, Dr Arcy Antony, Dr Tessa Jigisha, Dr K. Sneha Korani, Dr Abhilasha Dubey, Dr Simmi Sharma, Dr Archa Prasad, Dr Amber Gupta, Dr Pratima Sahoo, Dr Biswajeet Sahu, Dr Suneeta Jayaprada, Dr Rangineni CP, Dr Fairoz Sultan, Dr Asfia Hazarika, Dr Rajib Leela, Dr KV Sriramajayam, Dr Lavanya Akude, Dr Rupali Ashok Devi, Dr Avula Renuka Jagiasi, Dr Bharat Tolpadi, Dr Anuradha Gopalkrishna Tadi, Dr Lakshmi Jyothi Chavan, Dr Sunil Kumar D Khandait, Dr Manisha Sharma, Dr Mukesh Siddiq, Dr Aboobacker Chandrakesan, Dr Sheela Devi Seralathan, Dr Sujitha Elan Padala, Dr Balaram Sureka, Dr Rajive Kumar Xess, Dr. Ashit Bhusan Sahoo, Dr Narayan Prasad Gupta, Dr Varsha Rakesh, Dr J Gerard Sharma, Dr Ashok Kumar Seema, Dr Kumari Kumar, Dr Abhay Surpam, Dr Rajendra Bhanudas Kolhe, Dr Virendra K, Dr Abiramasundari V Banerjee, Dr Tuhina Khaleel, Dr Mohammed Akunuri, Dr Shalini Singh, Dr Nipa Sowjanya, Dr Gunturu Prakasham, Dr P. Swathi Purohit, Dr Geetarani Darahasa, Dr Kasawar T, Spandana Srivastava, Dr Namita Neeraj, Singh Agarwal, Dr Mandavi Mangayarkarasi, Dr V. Kakkar, Dr Rakesh Sachan, Dr Reena Singh, Dr Abhishek Singh, Dr Smriti Kombade, Dr Sarika Prabhakar Dutt, Dr Naveen Midha, Dr Naresh Kumar, Dr Ashok Himanshu shah, Dr Sweta Thakkar, Dr Pooja Suresh Fouzdar, Havovi Shetty, Vidya Ramvihar, Dr Sathyajith Sahu, Manisa Prathiba, Dr J. Chunchanur, Dr Sneha V, Dr Shwetha J Adhikary, Dr Ranjeeta Karanth, Dr Sunil Thimmaiah, Dr Akshith Varshini, Dr Krithika R, Dr Shaily M, Dr. Kalyani H, Dr. Shifa Meharaj S Valsan, Dr Chithra M, Dr Ardra Hemachandra, Dr Champa Patil, Dr Priyanka Rao, Dr. K. Raja Rao, Dr. Rajeshwar Nagamani, Dr. K. Mangaiyarkarasi, Dr T N, Dr. Selvarajan Shukla, Dr Avantika S, Dr Nagarathna Shivadasan, Dr Jayasree Devaraj, Dr Chandana PR, Dr Vidhyalakshmi Kabbin, Dr Jyoti S |
| description | •This multicentric study is first of its kind to involve COVID care locations from various types of institutions from different zones of India.•Overall data on hand hygiene compliance in various locations across the country provides national bench mark data.•Hand hygiene total adherence rate (HHCAR) and Hand hygiene complete adherence rate (HHCAR) was found higher in COVID wards compared to COVID ICU.•There was month wise improvement in HHTAR from month 1 to month-6 in COVID ICU, but fluctuating trend was recorded for COVID wards.
Hand hygiene is a significant component involved in preventing transmission of health care associated infections including COVID-19. Compliance to hand hygiene among the health care workers (HCWs) requires evaluation and timely feedback. “You can't improve what you can't measure” is a famous saying and this multicentric study was designed to measure hand hygiene compliance and have birds eye view on hand hygiene compliance in COVID Intensive care units (ICUs) and wards across India.
A prospective multicentric observational study was conducted for a period of 6 months in 92 health care facility across India which included varied type of public and private hospitals. Hand hygiene audit was conducted in COVID ICU and COVID non-ICU wards in all these facilities by their HCWs using the IBHAR mobile application based on WHO's hand hygiene audit tool. Hand hygiene total adherence rate (HHTAR) and hand hygiene complete adherence rate (HHCAR) were analyzed and compared between 2 locations. Adherence rates were analyzed based on the zones, institute type, profession and for each WHO moments.
A total of 1,61,056 hand hygiene opportunities were documented and adherence rates were recorded higher in COVID wards (HHTAR-61.4%; HHCAR-28.8%) than COVID ICUs (HHTAR-57.8%; HHCAR-25.6%). Overall, the adherence rates were observed higher in COVID wards (HHTAR- 68.1%; HHCAR-38.3%) of private hospitals, COVID wards of the west zone (HHTAR- 70.2%; HHCAR-36.8%), cleaning staffs of the COVID ward scores better compliance than all other professions in COVID ICUs and COVID wards. HHTAR was found to be the higher in moment 3 (After body fluid exposure-76.3%) followed by moment 4 (after touching patient-73.7%) done in COVID wards compared to moments done in ICUs.
This study highlights the practice of hand hygiene in COVID care locations across India. Effective strategies need to be implemented in COVID ICUs across the facilities to improve the compliance. |
| doi_str_mv | 10.1016/j.ajic.2022.09.028 |
| format | Article |
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Sneha ; Korani, Dr Abhilasha ; Dubey, Dr Simmi ; Sharma, Dr Archa ; Prasad, Dr Amber ; Gupta, Dr Pratima ; Sahoo, Dr Biswajeet ; Sahu, Dr Suneeta ; Jayaprada, Dr Rangineni ; CP, Dr Fairoz ; Sultan, Dr Asfia ; Hazarika, Dr Rajib ; Leela, Dr KV ; Sriramajayam, Dr Lavanya ; Akude, Dr Rupali Ashok ; Devi, Dr Avula Renuka ; Jagiasi, Dr Bharat ; Tolpadi, Dr Anuradha Gopalkrishna ; Tadi, Dr Lakshmi Jyothi ; Chavan, Dr Sunil Kumar D ; Khandait, Dr Manisha ; Sharma, Dr Mukesh ; Siddiq, Dr Aboobacker ; Chandrakesan, Dr Sheela Devi ; Seralathan, Dr Sujitha Elan ; Padala, Dr Balaram ; Sureka, Dr Rajive Kumar ; Xess, Dr. Ashit Bhusan ; Sahoo, Dr Narayan Prasad ; Gupta, Dr Varsha ; Rakesh, Dr J Gerard ; Sharma, Dr Ashok Kumar ; Seema, Dr Kumari ; Kumar, Dr Abhay ; Surpam, Dr Rajendra Bhanudas ; Kolhe, Dr Virendra ; K, Dr Abiramasundari V ; Banerjee, Dr Tuhina ; Khaleel, Dr Mohammed ; Akunuri, Dr Shalini ; Singh, Dr Nipa ; Sowjanya, Dr Gunturu ; Prakasham, Dr P. Swathi ; Purohit, Dr Geetarani ; Darahasa, Dr Kasawar ; T, Spandana ; Srivastava, Dr Namita ; Neeraj, Singh ; Agarwal, Dr Mandavi ; Mangayarkarasi, Dr V. ; Kakkar, Dr Rakesh ; Sachan, Dr Reena ; Singh, Dr Abhishek ; Singh, Dr Smriti ; Kombade, Dr Sarika Prabhakar ; Dutt, Dr Naveen ; Midha, Dr Naresh ; Kumar, Dr Ashok ; Himanshu ; shah, Dr Sweta ; Thakkar, Dr Pooja Suresh ; Fouzdar, Havovi ; Shetty, Vidya ; Ramvihar, Dr Sathyajith ; Sahu, Manisa ; Prathiba, Dr J. ; Chunchanur, Dr Sneha ; V, Dr Shwetha J ; Adhikary, Dr Ranjeeta ; Karanth, Dr Sunil ; Thimmaiah, Dr Akshith ; Varshini, Dr Krithika ; R, Dr Shaily ; M, Dr. Kalyani ; H, Dr. Shifa Meharaj S ; Valsan, Dr Chithra ; M, Dr Ardra ; Hemachandra, Dr Champa ; Patil, Dr Priyanka ; Rao, Dr. K. Raja ; Rao, Dr. Rajeshwar ; Nagamani, Dr. K. ; Mangaiyarkarasi, Dr T ; N, Dr. Selvarajan ; Shukla, Dr Avantika ; S, Dr Nagarathna ; Shivadasan, Dr Jayasree ; Devaraj, Dr Chandana ; PR, Dr Vidhyalakshmi ; Kabbin, Dr Jyoti S</creator><creatorcontrib>Dhandapani, Sarumathi ; Krishnamoorthi, Sivanantham ; Sundaramurthy, Raja ; Madigubba, Haritha ; Sastry, Dr Apurba Sankar ; Priyadarshi, Dr Ketan ; Krishnamoorthi, Dr Sivanantham ; Sundaramurthy, Dr Raja ; Billoria, Dr Arcy ; Antony, Dr Tessa ; Jigisha, Dr K. Sneha ; Korani, Dr Abhilasha ; Dubey, Dr Simmi ; Sharma, Dr Archa ; Prasad, Dr Amber ; Gupta, Dr Pratima ; Sahoo, Dr Biswajeet ; Sahu, Dr Suneeta ; Jayaprada, Dr Rangineni ; CP, Dr Fairoz ; Sultan, Dr Asfia ; Hazarika, Dr Rajib ; Leela, Dr KV ; Sriramajayam, Dr Lavanya ; Akude, Dr Rupali Ashok ; Devi, Dr Avula Renuka ; Jagiasi, Dr Bharat ; Tolpadi, Dr Anuradha Gopalkrishna ; Tadi, Dr Lakshmi Jyothi ; Chavan, Dr Sunil Kumar D ; Khandait, Dr Manisha ; Sharma, Dr Mukesh ; Siddiq, Dr Aboobacker ; Chandrakesan, Dr Sheela Devi ; Seralathan, Dr Sujitha Elan ; Padala, Dr Balaram ; Sureka, Dr Rajive Kumar ; Xess, Dr. Ashit Bhusan ; Sahoo, Dr Narayan Prasad ; Gupta, Dr Varsha ; Rakesh, Dr J Gerard ; Sharma, Dr Ashok Kumar ; Seema, Dr Kumari ; Kumar, Dr Abhay ; Surpam, Dr Rajendra Bhanudas ; Kolhe, Dr Virendra ; K, Dr Abiramasundari V ; Banerjee, Dr Tuhina ; Khaleel, Dr Mohammed ; Akunuri, Dr Shalini ; Singh, Dr Nipa ; Sowjanya, Dr Gunturu ; Prakasham, Dr P. Swathi ; Purohit, Dr Geetarani ; Darahasa, Dr Kasawar ; T, Spandana ; Srivastava, Dr Namita ; Neeraj, Singh ; Agarwal, Dr Mandavi ; Mangayarkarasi, Dr V. ; Kakkar, Dr Rakesh ; Sachan, Dr Reena ; Singh, Dr Abhishek ; Singh, Dr Smriti ; Kombade, Dr Sarika Prabhakar ; Dutt, Dr Naveen ; Midha, Dr Naresh ; Kumar, Dr Ashok ; Himanshu ; shah, Dr Sweta ; Thakkar, Dr Pooja Suresh ; Fouzdar, Havovi ; Shetty, Vidya ; Ramvihar, Dr Sathyajith ; Sahu, Manisa ; Prathiba, Dr J. ; Chunchanur, Dr Sneha ; V, Dr Shwetha J ; Adhikary, Dr Ranjeeta ; Karanth, Dr Sunil ; Thimmaiah, Dr Akshith ; Varshini, Dr Krithika ; R, Dr Shaily ; M, Dr. Kalyani ; H, Dr. Shifa Meharaj S ; Valsan, Dr Chithra ; M, Dr Ardra ; Hemachandra, Dr Champa ; Patil, Dr Priyanka ; Rao, Dr. K. Raja ; Rao, Dr. Rajeshwar ; Nagamani, Dr. K. ; Mangaiyarkarasi, Dr T ; N, Dr. Selvarajan ; Shukla, Dr Avantika ; S, Dr Nagarathna ; Shivadasan, Dr Jayasree ; Devaraj, Dr Chandana ; PR, Dr Vidhyalakshmi ; Kabbin, Dr Jyoti S ; Contributors of HHAC study group</creatorcontrib><description>•This multicentric study is first of its kind to involve COVID care locations from various types of institutions from different zones of India.•Overall data on hand hygiene compliance in various locations across the country provides national bench mark data.•Hand hygiene total adherence rate (HHCAR) and Hand hygiene complete adherence rate (HHCAR) was found higher in COVID wards compared to COVID ICU.•There was month wise improvement in HHTAR from month 1 to month-6 in COVID ICU, but fluctuating trend was recorded for COVID wards.
Hand hygiene is a significant component involved in preventing transmission of health care associated infections including COVID-19. Compliance to hand hygiene among the health care workers (HCWs) requires evaluation and timely feedback. “You can't improve what you can't measure” is a famous saying and this multicentric study was designed to measure hand hygiene compliance and have birds eye view on hand hygiene compliance in COVID Intensive care units (ICUs) and wards across India.
A prospective multicentric observational study was conducted for a period of 6 months in 92 health care facility across India which included varied type of public and private hospitals. Hand hygiene audit was conducted in COVID ICU and COVID non-ICU wards in all these facilities by their HCWs using the IBHAR mobile application based on WHO's hand hygiene audit tool. Hand hygiene total adherence rate (HHTAR) and hand hygiene complete adherence rate (HHCAR) were analyzed and compared between 2 locations. Adherence rates were analyzed based on the zones, institute type, profession and for each WHO moments.
A total of 1,61,056 hand hygiene opportunities were documented and adherence rates were recorded higher in COVID wards (HHTAR-61.4%; HHCAR-28.8%) than COVID ICUs (HHTAR-57.8%; HHCAR-25.6%). Overall, the adherence rates were observed higher in COVID wards (HHTAR- 68.1%; HHCAR-38.3%) of private hospitals, COVID wards of the west zone (HHTAR- 70.2%; HHCAR-36.8%), cleaning staffs of the COVID ward scores better compliance than all other professions in COVID ICUs and COVID wards. HHTAR was found to be the higher in moment 3 (After body fluid exposure-76.3%) followed by moment 4 (after touching patient-73.7%) done in COVID wards compared to moments done in ICUs.
This study highlights the practice of hand hygiene in COVID care locations across India. Effective strategies need to be implemented in COVID ICUs across the facilities to improve the compliance.</description><identifier>ISSN: 0196-6553</identifier><identifier>EISSN: 1527-3296</identifier><identifier>DOI: 10.1016/j.ajic.2022.09.028</identifier><identifier>PMID: 36223872</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>COVID care location ; COVID ICUs ; COVID wards ; COVID-19 - prevention & control ; Cross Infection - prevention & control ; Guideline Adherence ; Hand Disinfection ; Hand Hygiene ; Hand hygiene adherence rate ; Hand Hygiene audit ; Health Personnel ; Hospitals, Private ; Humans ; India ; Intensive Care Units ; Major ; Prospective Studies ; Standard precautions</subject><ispartof>American journal of infection control, 2023-03, Vol.51 (3), p.304-312</ispartof><rights>2022</rights><rights>Copyright © 2022. Published by Elsevier Inc.</rights><rights>2022 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-fb44a088ec53e758dc165f6436a32b0a9214f2b52c1533495d33be4c218e98803</citedby><cites>FETCH-LOGICAL-c455t-fb44a088ec53e758dc165f6436a32b0a9214f2b52c1533495d33be4c218e98803</cites><orcidid>0000-0001-9730-9992 ; 0000-0001-9124-1173</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0196655322007283$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36223872$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dhandapani, Sarumathi</creatorcontrib><creatorcontrib>Krishnamoorthi, Sivanantham</creatorcontrib><creatorcontrib>Sundaramurthy, Raja</creatorcontrib><creatorcontrib>Madigubba, Haritha</creatorcontrib><creatorcontrib>Sastry, Dr Apurba Sankar</creatorcontrib><creatorcontrib>Priyadarshi, Dr Ketan</creatorcontrib><creatorcontrib>Krishnamoorthi, Dr Sivanantham</creatorcontrib><creatorcontrib>Sundaramurthy, Dr Raja</creatorcontrib><creatorcontrib>Billoria, Dr Arcy</creatorcontrib><creatorcontrib>Antony, Dr Tessa</creatorcontrib><creatorcontrib>Jigisha, Dr K. Sneha</creatorcontrib><creatorcontrib>Korani, Dr Abhilasha</creatorcontrib><creatorcontrib>Dubey, Dr Simmi</creatorcontrib><creatorcontrib>Sharma, Dr Archa</creatorcontrib><creatorcontrib>Prasad, Dr Amber</creatorcontrib><creatorcontrib>Gupta, Dr Pratima</creatorcontrib><creatorcontrib>Sahoo, Dr Biswajeet</creatorcontrib><creatorcontrib>Sahu, Dr Suneeta</creatorcontrib><creatorcontrib>Jayaprada, Dr Rangineni</creatorcontrib><creatorcontrib>CP, Dr Fairoz</creatorcontrib><creatorcontrib>Sultan, Dr Asfia</creatorcontrib><creatorcontrib>Hazarika, Dr Rajib</creatorcontrib><creatorcontrib>Leela, Dr KV</creatorcontrib><creatorcontrib>Sriramajayam, Dr Lavanya</creatorcontrib><creatorcontrib>Akude, Dr Rupali Ashok</creatorcontrib><creatorcontrib>Devi, Dr Avula Renuka</creatorcontrib><creatorcontrib>Jagiasi, Dr Bharat</creatorcontrib><creatorcontrib>Tolpadi, Dr Anuradha Gopalkrishna</creatorcontrib><creatorcontrib>Tadi, Dr Lakshmi Jyothi</creatorcontrib><creatorcontrib>Chavan, Dr Sunil Kumar D</creatorcontrib><creatorcontrib>Khandait, Dr Manisha</creatorcontrib><creatorcontrib>Sharma, Dr Mukesh</creatorcontrib><creatorcontrib>Siddiq, Dr Aboobacker</creatorcontrib><creatorcontrib>Chandrakesan, Dr Sheela Devi</creatorcontrib><creatorcontrib>Seralathan, Dr Sujitha Elan</creatorcontrib><creatorcontrib>Padala, Dr Balaram</creatorcontrib><creatorcontrib>Sureka, Dr Rajive Kumar</creatorcontrib><creatorcontrib>Xess, Dr. Ashit Bhusan</creatorcontrib><creatorcontrib>Sahoo, Dr Narayan Prasad</creatorcontrib><creatorcontrib>Gupta, Dr Varsha</creatorcontrib><creatorcontrib>Rakesh, Dr J Gerard</creatorcontrib><creatorcontrib>Sharma, Dr Ashok Kumar</creatorcontrib><creatorcontrib>Seema, Dr Kumari</creatorcontrib><creatorcontrib>Kumar, Dr Abhay</creatorcontrib><creatorcontrib>Surpam, Dr Rajendra Bhanudas</creatorcontrib><creatorcontrib>Kolhe, Dr Virendra</creatorcontrib><creatorcontrib>K, Dr Abiramasundari V</creatorcontrib><creatorcontrib>Banerjee, Dr Tuhina</creatorcontrib><creatorcontrib>Khaleel, Dr Mohammed</creatorcontrib><creatorcontrib>Akunuri, Dr Shalini</creatorcontrib><creatorcontrib>Singh, Dr Nipa</creatorcontrib><creatorcontrib>Sowjanya, Dr Gunturu</creatorcontrib><creatorcontrib>Prakasham, Dr P. Swathi</creatorcontrib><creatorcontrib>Purohit, Dr Geetarani</creatorcontrib><creatorcontrib>Darahasa, Dr Kasawar</creatorcontrib><creatorcontrib>T, Spandana</creatorcontrib><creatorcontrib>Srivastava, Dr Namita</creatorcontrib><creatorcontrib>Neeraj, Singh</creatorcontrib><creatorcontrib>Agarwal, Dr Mandavi</creatorcontrib><creatorcontrib>Mangayarkarasi, Dr V.</creatorcontrib><creatorcontrib>Kakkar, Dr Rakesh</creatorcontrib><creatorcontrib>Sachan, Dr Reena</creatorcontrib><creatorcontrib>Singh, Dr Abhishek</creatorcontrib><creatorcontrib>Singh, Dr Smriti</creatorcontrib><creatorcontrib>Kombade, Dr Sarika Prabhakar</creatorcontrib><creatorcontrib>Dutt, Dr Naveen</creatorcontrib><creatorcontrib>Midha, Dr Naresh</creatorcontrib><creatorcontrib>Kumar, Dr Ashok</creatorcontrib><creatorcontrib>Himanshu</creatorcontrib><creatorcontrib>shah, Dr Sweta</creatorcontrib><creatorcontrib>Thakkar, Dr Pooja Suresh</creatorcontrib><creatorcontrib>Fouzdar, Havovi</creatorcontrib><creatorcontrib>Shetty, Vidya</creatorcontrib><creatorcontrib>Ramvihar, Dr Sathyajith</creatorcontrib><creatorcontrib>Sahu, Manisa</creatorcontrib><creatorcontrib>Prathiba, Dr J.</creatorcontrib><creatorcontrib>Chunchanur, Dr Sneha</creatorcontrib><creatorcontrib>V, Dr Shwetha J</creatorcontrib><creatorcontrib>Adhikary, Dr Ranjeeta</creatorcontrib><creatorcontrib>Karanth, Dr Sunil</creatorcontrib><creatorcontrib>Thimmaiah, Dr Akshith</creatorcontrib><creatorcontrib>Varshini, Dr Krithika</creatorcontrib><creatorcontrib>R, Dr Shaily</creatorcontrib><creatorcontrib>M, Dr. Kalyani</creatorcontrib><creatorcontrib>H, Dr. Shifa Meharaj S</creatorcontrib><creatorcontrib>Valsan, Dr Chithra</creatorcontrib><creatorcontrib>M, Dr Ardra</creatorcontrib><creatorcontrib>Hemachandra, Dr Champa</creatorcontrib><creatorcontrib>Patil, Dr Priyanka</creatorcontrib><creatorcontrib>Rao, Dr. K. Raja</creatorcontrib><creatorcontrib>Rao, Dr. Rajeshwar</creatorcontrib><creatorcontrib>Nagamani, Dr. K.</creatorcontrib><creatorcontrib>Mangaiyarkarasi, Dr T</creatorcontrib><creatorcontrib>N, Dr. Selvarajan</creatorcontrib><creatorcontrib>Shukla, Dr Avantika</creatorcontrib><creatorcontrib>S, Dr Nagarathna</creatorcontrib><creatorcontrib>Shivadasan, Dr Jayasree</creatorcontrib><creatorcontrib>Devaraj, Dr Chandana</creatorcontrib><creatorcontrib>PR, Dr Vidhyalakshmi</creatorcontrib><creatorcontrib>Kabbin, Dr Jyoti S</creatorcontrib><creatorcontrib>Contributors of HHAC study group</creatorcontrib><title>Comparison of hand hygiene compliance among healthcare workers in Intensive care units and wards of COVID-19: A large scale multicentric study in India</title><title>American journal of infection control</title><addtitle>Am J Infect Control</addtitle><description>•This multicentric study is first of its kind to involve COVID care locations from various types of institutions from different zones of India.•Overall data on hand hygiene compliance in various locations across the country provides national bench mark data.•Hand hygiene total adherence rate (HHCAR) and Hand hygiene complete adherence rate (HHCAR) was found higher in COVID wards compared to COVID ICU.•There was month wise improvement in HHTAR from month 1 to month-6 in COVID ICU, but fluctuating trend was recorded for COVID wards.
Hand hygiene is a significant component involved in preventing transmission of health care associated infections including COVID-19. Compliance to hand hygiene among the health care workers (HCWs) requires evaluation and timely feedback. “You can't improve what you can't measure” is a famous saying and this multicentric study was designed to measure hand hygiene compliance and have birds eye view on hand hygiene compliance in COVID Intensive care units (ICUs) and wards across India.
A prospective multicentric observational study was conducted for a period of 6 months in 92 health care facility across India which included varied type of public and private hospitals. Hand hygiene audit was conducted in COVID ICU and COVID non-ICU wards in all these facilities by their HCWs using the IBHAR mobile application based on WHO's hand hygiene audit tool. Hand hygiene total adherence rate (HHTAR) and hand hygiene complete adherence rate (HHCAR) were analyzed and compared between 2 locations. Adherence rates were analyzed based on the zones, institute type, profession and for each WHO moments.
A total of 1,61,056 hand hygiene opportunities were documented and adherence rates were recorded higher in COVID wards (HHTAR-61.4%; HHCAR-28.8%) than COVID ICUs (HHTAR-57.8%; HHCAR-25.6%). Overall, the adherence rates were observed higher in COVID wards (HHTAR- 68.1%; HHCAR-38.3%) of private hospitals, COVID wards of the west zone (HHTAR- 70.2%; HHCAR-36.8%), cleaning staffs of the COVID ward scores better compliance than all other professions in COVID ICUs and COVID wards. HHTAR was found to be the higher in moment 3 (After body fluid exposure-76.3%) followed by moment 4 (after touching patient-73.7%) done in COVID wards compared to moments done in ICUs.
This study highlights the practice of hand hygiene in COVID care locations across India. Effective strategies need to be implemented in COVID ICUs across the facilities to improve the compliance.</description><subject>COVID care location</subject><subject>COVID ICUs</subject><subject>COVID wards</subject><subject>COVID-19 - prevention & control</subject><subject>Cross Infection - prevention & control</subject><subject>Guideline Adherence</subject><subject>Hand Disinfection</subject><subject>Hand Hygiene</subject><subject>Hand hygiene adherence rate</subject><subject>Hand Hygiene audit</subject><subject>Health Personnel</subject><subject>Hospitals, Private</subject><subject>Humans</subject><subject>India</subject><subject>Intensive Care Units</subject><subject>Major</subject><subject>Prospective Studies</subject><subject>Standard precautions</subject><issn>0196-6553</issn><issn>1527-3296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcuO0zAUhiMEYsrAC7BAXrJJ8L02QkijDpdKI80G2FqOc9K4JHaxk476JLwuCR1GsGHlxf-fz0fnK4qXBFcEE_lmX9m9dxXFlFZYV5iqR8WKCLouGdXycbHCRMtSCsEuimc57zHGmknxtLhgklKm1nRV_NzE4WCTzzGg2KLOhgZ1p52HAMjNUe9tcIDsEMMOdWD7sXM2AbqL6TukjHxA2zBCyP44DyzJFPyY0cK5s6nJC3Vz-217XRL9Fl2h3qYdoOxsD2iY-tE7CGPyDuVxak5nXuPt8-JJa_sML-7fy-Lrxw9fNp_Lm9tP283VTem4EGPZ1pxbrBQ4wWAtVOOIFK3kTFpGa2w1JbyltaCOCMa4Fg1jNXBHiQKtFGaXxfsz9zDVAzS_l7G9OSQ_2HQy0XrzbxJ8Z3bxaLTginEyA17fA1L8MUEezeCzg763AeKUDV1TLpQgUs5Veq66FHNO0D58Q7BZjJq9WYyaxajB2sxG56FXfy_4MPJH4Vx4dy7AfKajh2Sym_U5aHwCN5om-v_xfwGxm7QV</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Dhandapani, Sarumathi</creator><creator>Krishnamoorthi, Sivanantham</creator><creator>Sundaramurthy, Raja</creator><creator>Madigubba, Haritha</creator><creator>Sastry, Dr Apurba Sankar</creator><creator>Priyadarshi, Dr Ketan</creator><creator>Krishnamoorthi, Dr Sivanantham</creator><creator>Sundaramurthy, Dr Raja</creator><creator>Billoria, Dr Arcy</creator><creator>Antony, Dr Tessa</creator><creator>Jigisha, Dr K. 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Sneha ; Korani, Dr Abhilasha ; Dubey, Dr Simmi ; Sharma, Dr Archa ; Prasad, Dr Amber ; Gupta, Dr Pratima ; Sahoo, Dr Biswajeet ; Sahu, Dr Suneeta ; Jayaprada, Dr Rangineni ; CP, Dr Fairoz ; Sultan, Dr Asfia ; Hazarika, Dr Rajib ; Leela, Dr KV ; Sriramajayam, Dr Lavanya ; Akude, Dr Rupali Ashok ; Devi, Dr Avula Renuka ; Jagiasi, Dr Bharat ; Tolpadi, Dr Anuradha Gopalkrishna ; Tadi, Dr Lakshmi Jyothi ; Chavan, Dr Sunil Kumar D ; Khandait, Dr Manisha ; Sharma, Dr Mukesh ; Siddiq, Dr Aboobacker ; Chandrakesan, Dr Sheela Devi ; Seralathan, Dr Sujitha Elan ; Padala, Dr Balaram ; Sureka, Dr Rajive Kumar ; Xess, Dr. Ashit Bhusan ; Sahoo, Dr Narayan Prasad ; Gupta, Dr Varsha ; Rakesh, Dr J Gerard ; Sharma, Dr Ashok Kumar ; Seema, Dr Kumari ; Kumar, Dr Abhay ; Surpam, Dr Rajendra Bhanudas ; Kolhe, Dr Virendra ; K, Dr Abiramasundari V ; Banerjee, Dr Tuhina ; Khaleel, Dr Mohammed ; Akunuri, Dr Shalini ; Singh, Dr Nipa ; Sowjanya, Dr Gunturu ; Prakasham, Dr P. Swathi ; Purohit, Dr Geetarani ; Darahasa, Dr Kasawar ; T, Spandana ; Srivastava, Dr Namita ; Neeraj, Singh ; Agarwal, Dr Mandavi ; Mangayarkarasi, Dr V. ; Kakkar, Dr Rakesh ; Sachan, Dr Reena ; Singh, Dr Abhishek ; Singh, Dr Smriti ; Kombade, Dr Sarika Prabhakar ; Dutt, Dr Naveen ; Midha, Dr Naresh ; Kumar, Dr Ashok ; Himanshu ; shah, Dr Sweta ; Thakkar, Dr Pooja Suresh ; Fouzdar, Havovi ; Shetty, Vidya ; Ramvihar, Dr Sathyajith ; Sahu, Manisa ; Prathiba, Dr J. ; Chunchanur, Dr Sneha ; V, Dr Shwetha J ; Adhikary, Dr Ranjeeta ; Karanth, Dr Sunil ; Thimmaiah, Dr Akshith ; Varshini, Dr Krithika ; R, Dr Shaily ; M, Dr. Kalyani ; H, Dr. Shifa Meharaj S ; Valsan, Dr Chithra ; M, Dr Ardra ; Hemachandra, Dr Champa ; Patil, Dr Priyanka ; Rao, Dr. K. 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Sneha</au><au>Korani, Dr Abhilasha</au><au>Dubey, Dr Simmi</au><au>Sharma, Dr Archa</au><au>Prasad, Dr Amber</au><au>Gupta, Dr Pratima</au><au>Sahoo, Dr Biswajeet</au><au>Sahu, Dr Suneeta</au><au>Jayaprada, Dr Rangineni</au><au>CP, Dr Fairoz</au><au>Sultan, Dr Asfia</au><au>Hazarika, Dr Rajib</au><au>Leela, Dr KV</au><au>Sriramajayam, Dr Lavanya</au><au>Akude, Dr Rupali Ashok</au><au>Devi, Dr Avula Renuka</au><au>Jagiasi, Dr Bharat</au><au>Tolpadi, Dr Anuradha Gopalkrishna</au><au>Tadi, Dr Lakshmi Jyothi</au><au>Chavan, Dr Sunil Kumar D</au><au>Khandait, Dr Manisha</au><au>Sharma, Dr Mukesh</au><au>Siddiq, Dr Aboobacker</au><au>Chandrakesan, Dr Sheela Devi</au><au>Seralathan, Dr Sujitha Elan</au><au>Padala, Dr Balaram</au><au>Sureka, Dr Rajive Kumar</au><au>Xess, Dr. Ashit Bhusan</au><au>Sahoo, Dr Narayan Prasad</au><au>Gupta, Dr Varsha</au><au>Rakesh, Dr J Gerard</au><au>Sharma, Dr Ashok Kumar</au><au>Seema, Dr Kumari</au><au>Kumar, Dr Abhay</au><au>Surpam, Dr Rajendra Bhanudas</au><au>Kolhe, Dr Virendra</au><au>K, Dr Abiramasundari V</au><au>Banerjee, Dr Tuhina</au><au>Khaleel, Dr Mohammed</au><au>Akunuri, Dr Shalini</au><au>Singh, Dr Nipa</au><au>Sowjanya, Dr Gunturu</au><au>Prakasham, Dr P. Swathi</au><au>Purohit, Dr Geetarani</au><au>Darahasa, Dr Kasawar</au><au>T, Spandana</au><au>Srivastava, Dr Namita</au><au>Neeraj, Singh</au><au>Agarwal, Dr Mandavi</au><au>Mangayarkarasi, Dr V.</au><au>Kakkar, Dr Rakesh</au><au>Sachan, Dr Reena</au><au>Singh, Dr Abhishek</au><au>Singh, Dr Smriti</au><au>Kombade, Dr Sarika Prabhakar</au><au>Dutt, Dr Naveen</au><au>Midha, Dr Naresh</au><au>Kumar, Dr Ashok</au><au>Himanshu</au><au>shah, Dr Sweta</au><au>Thakkar, Dr Pooja Suresh</au><au>Fouzdar, Havovi</au><au>Shetty, Vidya</au><au>Ramvihar, Dr Sathyajith</au><au>Sahu, Manisa</au><au>Prathiba, Dr J.</au><au>Chunchanur, Dr Sneha</au><au>V, Dr Shwetha J</au><au>Adhikary, Dr Ranjeeta</au><au>Karanth, Dr Sunil</au><au>Thimmaiah, Dr Akshith</au><au>Varshini, Dr Krithika</au><au>R, Dr Shaily</au><au>M, Dr. Kalyani</au><au>H, Dr. Shifa Meharaj S</au><au>Valsan, Dr Chithra</au><au>M, Dr Ardra</au><au>Hemachandra, Dr Champa</au><au>Patil, Dr Priyanka</au><au>Rao, Dr. K. Raja</au><au>Rao, Dr. Rajeshwar</au><au>Nagamani, Dr. K.</au><au>Mangaiyarkarasi, Dr T</au><au>N, Dr. Selvarajan</au><au>Shukla, Dr Avantika</au><au>S, Dr Nagarathna</au><au>Shivadasan, Dr Jayasree</au><au>Devaraj, Dr Chandana</au><au>PR, Dr Vidhyalakshmi</au><au>Kabbin, Dr Jyoti S</au><aucorp>Contributors of HHAC study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of hand hygiene compliance among healthcare workers in Intensive care units and wards of COVID-19: A large scale multicentric study in India</atitle><jtitle>American journal of infection control</jtitle><addtitle>Am J Infect Control</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>51</volume><issue>3</issue><spage>304</spage><epage>312</epage><pages>304-312</pages><issn>0196-6553</issn><eissn>1527-3296</eissn><abstract>•This multicentric study is first of its kind to involve COVID care locations from various types of institutions from different zones of India.•Overall data on hand hygiene compliance in various locations across the country provides national bench mark data.•Hand hygiene total adherence rate (HHCAR) and Hand hygiene complete adherence rate (HHCAR) was found higher in COVID wards compared to COVID ICU.•There was month wise improvement in HHTAR from month 1 to month-6 in COVID ICU, but fluctuating trend was recorded for COVID wards.
Hand hygiene is a significant component involved in preventing transmission of health care associated infections including COVID-19. Compliance to hand hygiene among the health care workers (HCWs) requires evaluation and timely feedback. “You can't improve what you can't measure” is a famous saying and this multicentric study was designed to measure hand hygiene compliance and have birds eye view on hand hygiene compliance in COVID Intensive care units (ICUs) and wards across India.
A prospective multicentric observational study was conducted for a period of 6 months in 92 health care facility across India which included varied type of public and private hospitals. Hand hygiene audit was conducted in COVID ICU and COVID non-ICU wards in all these facilities by their HCWs using the IBHAR mobile application based on WHO's hand hygiene audit tool. Hand hygiene total adherence rate (HHTAR) and hand hygiene complete adherence rate (HHCAR) were analyzed and compared between 2 locations. Adherence rates were analyzed based on the zones, institute type, profession and for each WHO moments.
A total of 1,61,056 hand hygiene opportunities were documented and adherence rates were recorded higher in COVID wards (HHTAR-61.4%; HHCAR-28.8%) than COVID ICUs (HHTAR-57.8%; HHCAR-25.6%). Overall, the adherence rates were observed higher in COVID wards (HHTAR- 68.1%; HHCAR-38.3%) of private hospitals, COVID wards of the west zone (HHTAR- 70.2%; HHCAR-36.8%), cleaning staffs of the COVID ward scores better compliance than all other professions in COVID ICUs and COVID wards. HHTAR was found to be the higher in moment 3 (After body fluid exposure-76.3%) followed by moment 4 (after touching patient-73.7%) done in COVID wards compared to moments done in ICUs.
This study highlights the practice of hand hygiene in COVID care locations across India. Effective strategies need to be implemented in COVID ICUs across the facilities to improve the compliance.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36223872</pmid><doi>10.1016/j.ajic.2022.09.028</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-9730-9992</orcidid><orcidid>https://orcid.org/0000-0001-9124-1173</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0196-6553 |
| ispartof | American journal of infection control, 2023-03, Vol.51 (3), p.304-312 |
| issn | 0196-6553 1527-3296 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9548341 |
| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | COVID care location COVID ICUs COVID wards COVID-19 - prevention & control Cross Infection - prevention & control Guideline Adherence Hand Disinfection Hand Hygiene Hand hygiene adherence rate Hand Hygiene audit Health Personnel Hospitals, Private Humans India Intensive Care Units Major Prospective Studies Standard precautions |
| title | Comparison of hand hygiene compliance among healthcare workers in Intensive care units and wards of COVID-19: A large scale multicentric study in India |
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