Department of Microbiology, All India Institute of Medical Sciences, Bathinda, Punjab, India.
Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Indian J Med Microbiol. 2023 May-Jun;43:39-48. doi: 10.1016/j.ijmmb.2022.09.002. Epub 2022 Oct 1.
Hand hygiene (HH), the core element in infection prevention in healthcare, especially for multidrug resistant organism's transmission. The role of HH audits and HH adherence rates in the COVID-19 pandemic, especially in resource limited settings, are yet to be established.
A nationwide multicenter study was conducted in India, involving public, private, teaching and non-teaching COVID healthcare facilities (COVID-HCFs) using the IBhar mobile application based on WHO's hand hygiene audit tool. The HH adherence rates (HHAR) such as complete HHAR (HHCAR), total HHAR (HHTAR), profession specific HHAR, WHO's 5 HH moment specific HHAR and associated variables were measured over 6 month duration (June-December 2021).
A total of 2,01,829 HH opportunities were available and the HHCAR and HHTAR were 27.3% and 59.7%. The HHTAR was significantly higher in the west zone (72.2%), private institutes (65.6%), non-teaching institutes (67.7%), nurses (61.6%), HH moments 2 (71.8%) and 3 (72.1%), and morning shift (61.4%). The HHTAR was better in non-COVID HCFs (65.4%) than COVID-HCFs (57.8%) as well as non-COVID ICUs (68.1%) than COVID ICUs (58.7%). The HHTAR was increased from month 1 to month 6 except a small decrease in the month of December.
The hand hygiene adherence is comparable with adherence rate during COVID-19 pandemic in western countries as well as the resource limited settings. The use of gloves during the pandemic and simplified HH techniques and their influence over the HH adherence to be studied further. The sustainable adherence rate over long duration needs to be ensured by continuing the HH audit using multimodal interventions.
手卫生（HH）是医疗机构感染预防的核心要素，尤其对于多重耐药菌的传播。在 COVID-19 大流行期间，尤其是在资源有限的环境中，HH 审核和 HH 依从率的作用尚未确定。
在印度进行了一项全国性多中心研究，涉及公共、私人、教学和非教学 COVID 医疗保健机构（COVID-HCF），使用基于世卫组织手卫生审核工具的 IBhar 移动应用程序。在 6 个月的时间内（2021 年 6 月至 12 月），测量了 HH 依从率（HHAR），如完全 HHAR（HHCAR）、总 HHAR（HHTAR）、专业特定 HHAR、世卫组织的 5 个 HH 时刻特定 HHAR 和相关变量。
共有 201829 个 HH 机会，HHCAR 和 HHTAR 分别为 27.3%和 59.7%。HH 时刻 2（71.8%）和 3（72.1%）以及早班（61.4%）的 HHTAR 显著更高。西部分区（72.2%）、私立机构（65.6%）、非教学机构（67.7%）、护士（61.6%）的 HHTAR 更高。非 COVID-HCF（65.4%）的 HHTAR 优于 COVID-HCF（57.8%），非 COVID-ICU（68.1%）优于 COVID-ICU（58.7%）。HHAR 从 1 月到 6 月逐月增加，除 12 月略有下降外。
与 COVID-19 大流行期间西方国家以及资源有限环境中的依从率相比，手卫生依从率相当。需要进一步研究在大流行期间使用手套以及简化 HH 技术及其对 HH 依从性的影响。需要通过持续使用多模式干预进行 HH 审核来确保长期的可持续依从率。
