Русский
Assessment of medical workers' adherence to hygiene and hand antiseptics in pre-pandemic and pandemic periods
DOI: https://dx.doi.org/10.18565/epidem.2023.13.4.39-49
Smirnova S.S., Malkova E.V., Egorov I.A., Zhuikov N.N., Mishchenko V.A., Vyalykh I.V., Smirnova V.A., Bolshakova A.N., Semenov A.V.
1) Federal Research Institute of Viral Infections «Virom» of Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Yekaterinburg, Russia; 2) Ural State Medical University, Yekaterinburg, Russia; 3) Regional Children’s Clinical Hospital, Yekaterinburg, Russia; 4) Institute of Natural Sciences and Mathematics, Ural Federal University named after the First President of Russia B.N. Yeltsin, Yekaterinburg, Russia
Materials and methods. An anonymous survey of medical workers was conducted in 2012 (73 people) and 2021 (100 people), with a simultaneous study of the level of bacterial (2012) and viral-bacterial (2021) hand contamination. Epidemiological (descriptive-evaluative and analytical), molecular biological (RT-PCR), bacteriological and statistical methods were used.
Results. Medical workers’ knowledge levels were comparable across study periods. However, during the pandemic, medical workers’ ideas about the stages of hygienic antiseptics have changed. The total level of adherence to hand antisepsis in the pre-pandemic period was 63.1%, in the pandemic period – 72.6%. It was noted that the frequency of contamination of hands and the outer surface of gloves remained at a high level (in 2012 – 22.0%, in 2021 – 28.3%) and was represented by a wide range of viral and bacterial microflora (Staphylococcus aureus, Enterococcus spp., Klebsiella spp., Pantoea agglomerans, Pseudomonas aeruginosa and SARS-CoV-2). In a number of cases, the presence of viral-bacterial associations on hands (gloves) was detected.
Conclusion. Despite the predominantly positive attitude towards hand antisepsis, an increase in the proportion of ambiguous assessments was noted. The overall level of knowledge about situations requiring hand antiseptic has increased. But the results of laboratory studies of washes from the hands and outer surfaces of gloves of medical personnel demonstrated a high level of viral and bacterial contamination, which contributes to the creation of conditions for the circulation of viral and bacterial pathogens in a medical organization.
Literature
1. Lotfinejad N., Peters A., Tartari E., Fankhauser-Rodriguez C., Pires D., Pittet D. Hand hygiene in health care: 20 years of ongoing advances and perspectives. Lancet Infect. Dis. 2021: 21: e209–21. doi: 10.1016/S1473-3099(21)00383-2 2. Baccolini V., D’Egidio V., de Soccio P., Migliara G., Massimi A., Alessandri F. et al. Effectiveness over time of a multimodal intervention to improve compliance with standard hygiene precautions in an intensive care unit of a large teaching hospital. Antimicrob. Resist Infect. Control. 2019; 8: 92. doi: 10.1186/s13756-019-0544-0 3. Peters A., Lotfinejad N., Simniceanu A., Pittet D. The economics of infection prevention: why it is crucial to invest in hand hygiene and nurses during the novel coronavirus pandemic. J. Infect. 2020; 81(2): 318–56. doi: 10.1016/j.jinf.2020.04.029 4. Брусина Е.Б., Зуева Л.П., Ковалишена О.В., Стасенко В.Л., Фельдблюм И.В., Брико Н.И. Инфекции, связанные с оказанием медицинской помощи: современная доктрина профилактики. Часть 1. Исторические предпосылки. Эпидемиология и Вакцинопрофилактика 2018; 17(5); 17–24. DOI: 10.31631/2073-3046-2018-17-5-17-24 Brusina E.B., Zueva L.P., Kovalishena O.V., Stasenko V.L., Feldblum I.V., Briko N.I. (Healthcare-associated infections: modern doctrine of prophylaxis. Part I. Historical background). Epidemiology and Vaccinal Prevention 2018; 17(5); 17–24. (In Russ.). doi: 10.31631/2073-3046-2018-17-6-4-10 5. Haque M., McKimm J., Sartelli M., Dhingra S., Labricciosa F.M., Islam S. et al. Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview. Risk Manag. Healthc. Policy 2020; 13: 1765–80. doi: 10.2147/RMHP.S269315 6. Vermeil T., Peters A., Kilpatrick C., Pires D., Allegranzi B., Pittet D. Hand hygiene in hospitals: anatomy of a revolution. Journal of Hospital Infection 2019; 101(4): 383–92. doi: 10.1016/j.jhin.2018.09.003 7. Kalra S., Amin A., Albert N., Cadwell C., Edmonson C., Gaynesц R. et al. Stethoscope hygiene: A call to action. Recommendations to update the CDC guidelines. Infect. Control. Hosp. Epidemiol. 2021; 42(6): 740–2. doi: 10.1017/ice.2021.115 8. Lotfinejad N., Tuor C., Peters A., Pittet D. The duality of nurses’ work: How can the profession that saves the most lives in the world avoid spreading disease? International Journal of Nursing Studies 2020; 107: 103616. doi: 10.1016/j.ijnurstu.2020.103616 9. Tartari E., Kilpatrick C., Allegranzi B., Pittet D. «Unite for safety – clean your hands»: the 5 May 2022 World Health Organization SAVE LIVES – Clean Your Hands campaign. Antimicrob. Resist. Infect. Control. 2022; 11: 63. doi: 10.1186/s13756-022-01105-y 10. Руководство ВОЗ по гигиене рук в здравоохранении: Резюме. Женева: ВОЗ, 2013. 64 с. https://apps.who.int/iris/handle/10665/112367 (Guidelines on Hand Hygiene in Health Care: Summar). Geneva: WHO, 2013. 64 p. (In Russ.). https://apps.who.int/iris/handle/10665/112367 11. Разумова Д.В., Малышев В.В. Гигиена рук в системе профилактики инфекций, связанных с оказанием медицинской помощи. Клиническая больница 2018; (4): 56–9. Razumova D.V., Malyshev V.V. (Hand hygiene in the system of infection prevention, related to the provision of medical care). The Hospital 2018; (4): 56–9. (In Russ.). 12. Santy-Tomlinson J. We need to talk about hand hygiene: A time to reflect on compliance. International Journal of Orthopaedic and Trauma Nursing 2020; 39: 100819. doi: 10.1016/j.ijotn.2020.100819 13. Stadler RN., Tschudin-Sutter S. What is new with hand hygiene? Curr. Opin. Infect. Dis. 2020; 33(4): 327–32. doi: 10.1097/QCO.0000000000000654 14. Laher A.E., van Rooyen L.R., Jawa A., Enyuma C.O., Swartzberg K.M. Compliance with hygiene practices among healthcare workers at an academic hospital emergency department. Afr. J. Emerg. Med. 2021; 11(3): 352–5. doi: 10.1016/j.afjem.2021.05.002 15. Laher A.E., Van Rooyen L.R., Gerber L., Richards G.A. Compliance with hygiene practices among healthcare workers in the intensive care unit. S. Afr. Med. J. 2020; 110(8): 791–5. doi: 10.7196/SAMJ.2020.v110i8.14512 16. Kielar M., Depurbaix R., Agnyziak M., Wijaszka B., Poboży T. The COVID-19 pandemic as a factor of hospital staff compliance with the rules of hand hygiene: assessment of the usefulness of the «Clean Care is a Safer Care» program as a tool to enhance compliance with hand hygiene principles in hospitals. Journal of Preventive Medicine and Hygiene 2021; 62: e25–32. doi: 10.15167/2421-4248/jpmh2021.62.1.1603 17. Kumar A., Keri V.C., Khan M.A., Ranjan P., Rastogi N., Sahu M. et al. Assessment of healthcare worker›s hand hygiene and infection prevention practices of their personal belongings in a healthcare setting: a survey in pre COVID-19 era and literature review on standard disinfection practices. Journal of Preventive Medicine and Hygiene 2021; 62(1): e104–9. doi: 10.15167/2421-4248/jpmh2021.62.1.1742 18. Accardi R., Castaldi S., Marzullo A., Ronchi S., Laquintana D., Lusignani M. Prevention of healthcare associated infections: a descriptive study. Annali di igiene: medicina preventiva e di comunita 2017; 29(2): 101–15. doi: 10.7416/ai.2017.2137 19. Vikke H.S., Vittinghus S., Giebner M., Kolmos H.J., Smith K., Castren M. et al. Compliance with hand hygiene in mergency medical services: an international observational study. Emer. Med. J. 2019; 36: 171–5. doi: 10.1136/emermed-2018-207872 20. Брусина Е.Б., Зуева Л.П., Ковалишена О.В., Стасенко В.Л., Фельдблюм И.В., Брико Н.И. Инфекции, связанные с оказанием медицинской помощи: современная доктрина профилактики Часть 2. Основные положения. Эпидемиология и Вакцинопрофилактика 2018; 17(6): 4–10. doi: 10.31631/2073-3046-2018-17-6-4-10 Brusina E.B, Zueva L.P., Kovalishena O.V., Stasenko V.L., Feldblum I.V., Briko N.I. (Healthcare-associated infections: modern doctrine of prophylaxis. Part II. Basic concept). Epidemiology and Vaccinal Prevention 2018; 17(6): 4–10. (In Russ.). doi: 10.31631/2073-3046-2018-17-6-4-10 21. Novak M., Breznicky J., Kompanikova J., Malinovska N., Hudeckova H. Impact of hand hygiene knowledge on the hand hygiene compliance. Me. Glas (Zenica). 2020; 17: 194–9. doi: 10.17392/1051-20 22. Hammerschmidt J., Manser T. Nurses’ knowledge, behaviour and compliance concerning hand hygiene in nursing homes: a cross-sectional mixed-methods study. BMC Health Serv. Res. 2019; 19: 547. doi: 10.1186/s12913-019-4347-z. 23. Martos-Cabrera M.B., Mota-Romero E., Martos-Garcia R., Gomez-Urquiza J.L., Suleiman-Martos N., Albendin-Garcia L. et al. Hand Hygiene Teaching Strategies among Nursing Staff: A Systematic Review. Int. J. Environ Res. Public Health 2019; 17: 3039. doi: 10.3390/ijerph16173039 24. Stangerup M., Hansen MB., Hansen R. Palasin Sode L., Bjørn Hesselbo B., Kostadinov K. et al. Hand hygiene compliance of healthcare workers before and during the COVID-19 pandemic: A long-term follow-up study. Am. J. Infect. Control 2021; 49(9): 1118–22. DOI:10.1016/j.ajic.2021.06.014 25. Sandbøl S.G., Glassou E.N., Ellermann-Eriksen S., Haagerup A. Hand hygiene compliance among healthcare workers before and during the COVID-19 pandemic. Am. J. Infect. Control 2022; 50: 719–23. DOI: 10.1016/j.ajic.2022.03.014 26. Makhni S., Umscheid C.A., Soo J., Chu V., Bartlett A., Landon E. et al. Hand Hygiene Compliance Rate During the COVID-19 Pandemic. JAMA Intern. Med. 2021; 181: 1006–8. doi: 10.1001/jamainternmed.2021.1429 27. Abalkhail A., Mahmud I., Alhumaydhi F.A., Alslamah T., Alwashmi A.S.S, Vinnakota D. et al. Hand Hygiene Knowledge and Perception among the Healthcare Workers during the COVID- 19 Pandemic in Qassim, Saudi Arabia: A Cross-Sectional Survey. Healthcare (Basel). 2021; 24: 1627. doi: 10.3390/healthcare9121627 28. Espinoza E.P.S, Cortes M.F., Noguera S.V., Paula A.V., Guimarães T., Boas L.S.V. et al. Are mobile phones part of the chain of transmission of SARS-CoV-2 in hospital settings? Rev. Inst. Med. Trop Sao Paulo 2021; 63(27): e74. doi: 10.1590/S1678-9946202163074 29. Hamdan-Partido A., González-García S., Martínez-Ruíz F.J., Zavala-Sánchez M.Á., Bustos-Hamdan A., Bustos-Martínez J. Molecular Characterization of Staphylococcus aureus Strains Isolated from Mobile Phones. Microorganisms 2022; (10): 669. doi: 10.3390/microorganisms10030669 30. Rayson D., Basinda N., Pius R.A., Seni J. Comparison of hand hygiene compliance self-assessment and microbiological hand contamination among healthcare workers in Mwanza Region, Tanzania. Infect. Prev. Pract. 2021; 23: 100181. doi: 10.1016/j.infpip.2021.100181 31. Rundle C.W., Presley C.L., Militello M., Barber C., Powell D.L., Jacob S.E. et al. Hand hygiene during COVID-19: Recommendations from the American Contact Dermatitis Society. J. Am. Acad. Dermatol. 2020; 83: 1730–7. doi: 10.1016/j.jaad.2020.07.057 32. Hu K., Fan J., Li X., Gou X., Li X., Zhou X. The adverse skin reactions of health care workers using personal protective equipment for COVID-19. Medicine (Baltimore) 2020; 99: e20603. doi: 10.1097/MD.0000000000020603 33. Lan J., Song Z., Miao X., Li H., Li Y., Dong L. et al. Skin damage among health care workers managing coronavirus disease-2019. J. Am. Acad. Dermatol. 2020; 82(5): 1215–6. doi: 10.1016/j.jaad.2020.03.014 34. Wang Y., Yang J., Qiao F., Feng B., Hu F., Xi Z.A. et al. Compared hand hygiene compliance among healthcare providers before and after the COVID-19 pandemic: A rapid review and meta-analysis. Am. J. Infect. Control. 2022; 50(5): 563–71. doi: 10.1016/j.ajic.2021.11.030 35. Moore L.D., Robbins G., Quinn J., Arbogast J.W. The impact of COVID-19 pandemic on hand hygiene performance in hospitals. Am. J. Infec.t Control. 2021; 49: 30–3. doi: 10.1016/j.ajic.2020.08.021
About the Autors
Svetlana S. Smirnova, Сand. Med. Sci., Leading Researcher,. Head, Ural-Siberian Scientific and Methodological Center for the Prevention of Healthcare-Acquired Infection, Federal Research Institute of Viral Infections «Virom», Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Associate Professor, Department of Epidemiology, Social Hygiene and Organization, State Sanitary and Epidemiological Service, Ural State Medical University, Yekaterinburg, Russia; smirnova_ss@niivirom.ru; https://orcid.org/0000-0002-9749-4611
Elena V. Malkova, Head, Laboratory for Testing Disinfectants and Equipment, Epidemiologist, Ural-Siberian Scientific and Methodological Center for the Prevention of Healthcare-Acquired Infections, Federal Research Institute of Viral Infections «Virom», Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Yekaterinburg, Russia; malkova_ev@niivirom.ru.ru; https://orcid.org/0000-0002-6647-9531
Ivan A. Egorov, Junior Researcher, Ural-Siberian Scientific and Methodological Center for the Prevention of Infections Associated with the Provision of Medical Care, Federal Research Institute of Viral Infections «Virom», Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Yekaterinburg, Russia; egorov_ia@niivirom.ru; https://orcid.org/0000-0002-7153-2827
Nikolai N. Zhuikov, Researcher, Ural-Siberian Scientific and Methodological Center for the of Infections Associated with the Provision of Medical Care, Federal Research Institute of Viral Infections «Virom», Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Yekaterinburg, Russia; zhuikov_nn@niivirom.ru; https://orcid.org/0000-0002-7018-7582
Vladimir A. Mishchenko, Laboratory of Transmissible Viral Infections and Tick-Borne Encephalitis, Federal Research Institute of Viral Infections «Virom» Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Yekaterinburg, Russia; mischenko_va@niivirom.ru; https://orcid.org/0000-0003-4280-283X
Ivan V. Vialykh, Сand. Med. Sci., Leading Researcher, Head, Laboratory of Transmissible Viral Infections and Tick-Borne Encephalitis, Federal Research Institute of Viral Infections «Virom», Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Yekaterinburg, Russia; vjalyh_iv@niivirom.ru; https://orcid.org/0000-0002-3123-8359
Veronika A. Smirnova, Head, Epidemiological Department, Regional Children’s Clinical Hospital, Yekaterinburg, Russia; smirnovava@mis66.ru; https://orcid.org/0000-0002-9657-4257
Angelina N. Bolshakova, Epidemiologist, Regional Children’s Clinical Hospital, Yekaterinburg, Russia; anbolshakova73@gmail.com; https://orcid.org/0000-0001-7678-6984
Aleksandr V. Semenov, ВD., Director, Federal Research Institute of Viral Infections «Virom», Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Professor, Department of Experimental Biology and Biotechnology, Institute of Natural Sciences and Mathematics, Ural Federal University named after the First President of Russia B.N. Yeltsin Yekaterinburg, Russia; semenov_av@niivirom.ru; https://orcid.org/0000-0003-3223-8219
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