• Users Online: 669
  • Print this page
  • Email this page


 
 
Table of Contents
ORIGINAL ARTICLE
Year : 2021  |  Volume : 18  |  Issue : 2  |  Page : 73-75

Awareness of hand hygiene among physicians at Benghazi Medical Center during COVID-19 pandemic. A cross sectional study


1 Department of Internal Medicine, Aljomhorya Hospital, Benghazi, Libya
2 Intern Doctor, Faculty of Medicine, Libyan International Medical University, Benghazi, Libya
3 Department of Internal Medicine, Faculty of Medicine, Benghazi University, Benghazi, Libya

Date of Submission03-Oct-2020
Date of Decision25-Jan-2021
Date of Acceptance28-Jan-2021
Date of Web Publication06-May-2021

Correspondence Address:
Khaled D Alsaeiti
Department of Internal Medicine, Aljamhorya Hospital, Benghazi
Libya
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/am.am_119_20

Rights and Permissions
  Abstract 


Introduction: Hands of the physicians play a significant role in the transmission of nosocomial infections; the aim of the current study is to describe the physician's knowledge regarding hand hygiene (HH) and their compliance to that during their daily round. Materials and Methods: A cross-sectional descriptive study was conducted among physicians working at Benghazi Medical Center during May 2020. We used WHO's HH questionnaire for healthcare workers. The maximum score obtainable for knowledge was 25. The practice of HH was assessed by a self-designed questionnaire. Results: A total of 250 out of 276 giving a response rate of 90.5%. Physicians with work experience of 5 years or less constituted the highest involved group (68%). Based on the WHO HH questionnaire a moderate level of knowledge prevailed (45.2%) followed by a good (36%) and poor (18.8%) level of knowledge respectively, and as expected the highest level of good knowledge was found among those with more than 10 years of work experience. Regarding HH practice, most of the studied group prefer to use alcohol-based hand rub routinely 112/250, the same findings regarding Frequency of performing HH in the daily round. Strangely 182 (72.8%) say that HH is effective in controlling COVID-19 while only 134 (53.6%) say that protects physicians against COVID-19, though in their knowledge, most of our physicians prefer to perform quick HH method. Conclusion: HH is an important tool for the prevention of the COVID19 pandemic. The overall knowledge and practice of HH were moderate to good among study subjects and few numbers of physicians had attended formal training about HH in the last 3 years. These findings indicate that our physicians require increased emphasis on HH

Keywords: COVID-19, hand, hygiene


How to cite this article:
Alsaeiti KD, A. Benali SM, Hamedh MA, Ibkhatra SA. Awareness of hand hygiene among physicians at Benghazi Medical Center during COVID-19 pandemic. A cross sectional study. Apollo Med 2021;18:73-5

How to cite this URL:
Alsaeiti KD, A. Benali SM, Hamedh MA, Ibkhatra SA. Awareness of hand hygiene among physicians at Benghazi Medical Center during COVID-19 pandemic. A cross sectional study. Apollo Med [serial online] 2021 [cited 2021 Jul 25];18:73-5. Available from: https://www.apollomedicine.org/text.asp?2021/18/2/73/315583




  Introduction Top


Hygiene is basically defined as a branch of science which is involved in knowledge and practices related to the promotion of health.[1] The hands of the physicians play a significant role in the transmission of nosocomial infections.[2] It is a major cause of increasing morbidity, mortality, and health care costs among hospitalized patients worldwide,[3] in usual situations before the COVID-19 pandemic physicians wash their hands less than half of the time they should.[4] Improved compliance in HH, with proper use of alcohol-based hand rubs (ABHRs) can reduce the nosocomial infection rate by as much as 40%.[5] According to the WHO guidelines, HH implies hand wash with water and soap and/or hand rub. HH must be conducted in relation to the following five situations; before patient contact, before aseptic or clean procedures, after the risk of contact with body fluids, for example, blood, secretions, after patient contact, and after being in contact with patient-near surroundings. Furthermore, HH must be performed before putting on gloves and after glove removal. Moreover, the use of gloves should be restrained to patient-care activities that involve risk of exposure to blood and all other body fluids, for example, if in contact with mucous membranes and nonintact skin, and during contact precautions or in outbreak situations.[6]

Several factors are associated with poor compliance of These factors are lack of awareness and knowledge with regard to importance, techniques, methods and quality of HH, presence of individual towel/tissues, availability of HH agent, automated sinks, location of sinks, workload, or lack of institutional priorities.[7]

The aim of the current study is to describe the physician's knowledge regarding HH and their compliance with that during their daily round.


  Materials and Methods Top


A cross-sectional descriptive study was conducted among physicians working at Benghazi Medical Center during May 2020. Verbal consent was taken from the participating physicians working in the medical department. However, out of 270 questionnaires, 20 were excluded because of incomplete data.

To assess knowledge of hand hygiene (HH) among participants, we used WHO's HH questionnaire for healthcare workers.[8] The questionnaire comprised 25 questions; each correct answer was given one point, and an incorrect answer was given zero. The answers to these questions were yes or no options. The maximum score obtainable for knowledge was 25. The scores were calculated and expressed in percentage. An overall score of >75% was considered good, 50%–74% moderate, and <50% was considered as poor. The practice of HH was assessed by a self-designed questionnaire, which was reviewed by the infection control team in Benghazi medical center. The data regarding knowledge and practice of HH was analyzed using SPSS version 17.0 software (SPSS; SPSS Inc., Chicago, IL, USA). Descriptive statistics were used to calculate percentages for knowledge and practice of study subjects.


  Results Top


Total of 250 out of 276 were completely fill the questionnaire, giving response rate of 90.5%. The demographic characteristics [Table 1] showed that physicians with work experience 5 years or less constituted the highest group (68%). Based on the WHO HH questionnaire a moderate level of knowledge prevailed (45.2%) followed by a good (36%) and poor (18.8%) level of knowledge, respectively, and as expected the highest level of good knowledge was found among those with >10 years of work experience.
Table 1: Demographic distribution of the studied group

Click here to view


Regarding HH practice, most of the studied groups prefer to use ABHR routinely 112/250, the same findings regarding Frequency of performing HH in the daily round.

Strangely 182 (72.8%) say that HH is effective in controlling COVID-19 while only 134 (53.6%) say that protects physicians against COVID-19, though in their knowledge, most of our physicians prefer to perform quick HH method. All responses are shown in [Table 2].
Table 2: Responses for knowledge based questions and practice related to hand hygiene

Click here to view



  Discussion Top


Based on the WHO HH questionnaire a moderate level of knowledge prevailed (45.2%) followed by a good (36%) and poor (18.8%) level of knowledge, respectively, these results are not surprising due to the extensive emphasis on the burden of nosocomial infections during medical education, cultural customs of handwashing, and public service messages conveyed in advertisements and schools.

Interestingly, while the results do show an expected majority of good knowledge among the 10-year group, they also show a gap of 53% versus 27% in favor of the 5 years or less group against the 10-year group, this leading trend continues for the HH practice section and the frequency of performing HH during the daily round with a close approximation in the more than three times answers.

According to our custom-designed questionnaire, 195 (78%) of the 250 respondents answered the purpose of HH correctly again the 5-year group held a higher level of knowledge in comparison to the other two groups.

Strangely 182 (72.8%) say that HH is effective in controlling COVID-19 while only 134 (53.6%) say that protects physicians against COVID-19 this may be a fear of neglect, where physicians are afraid of misleading public concern leading to an inadequate investment of protecting healthcare workers, this trend seen again in the 129 (51.6%) regarding the superiority of HH to any other method in controlling COVID-19 where respondents might struggle to find HH superior to other highly effective methods such as social distancing.

Furthermore, only 89 (35%) of the respondents knew the total number of HH steps, also 50% of the respondents attended infection control training courses or seminars.

Finally, 131 reports performing a comprehensive method of HH during their daily round while 111 reports performing a quick method of HH during their daily round.

Strengths and limitations

No recent studies were performed before the COVID-19 pandemic locally, nor studies since the publication of the WHO for a high-quality comparison and assessment of performance and knowledge adequacy.

We are unable to assess the quality of the Sample distribution among the 10-year group due to the lack of a reliable source reporting the total number of physicians with a 10 year plus experience.

Recommendations

We recommend performing comparative studies of the same design in economically varied health-care systems for a comprehensive norm-referenced assessment of HH quality.

Following a comparative study that defines a good HH quality an associative and causative study may be performed to assess the impact of HH on a pandemics burden in less ideal circumstances as opposed to circumstances of studies performed in the developed world.


  Conclusion Top


HH is an important tool for the prevention of the COVID-19 pandemic. The overall knowledge and practice of HH were moderate to good among study subjects and few numbers of physicians had attended formal training about HH in the past 3 years. These findings indicate that our physicians require increased emphasis on HH.

Acknowledgments

We would like to thank all our patients who cooperated in the data collection of this research.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Bloomfield SF, Aiello AE, Cookson B, O'Boyle C, Larson EL. The effectiveness of hand hygiene procedures in reducing the risks of infections in home and community settings including handwashing and alcohol-based hand sanitizers. American journal of infection control 2007;35:S27-64.  Back to cited text no. 1
    
2.
Kampf G, Kramer A. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev 2004;17:863-93.  Back to cited text no. 2
    
3.
Sydnor ER, Perl TM. Hospital epidemiology and infection control in acute-care settings. Clin Microbiol Rev 2011;24:141-73.  Back to cited text no. 3
    
4.
Greenstein B, Wood D. The Endocrine System at a Glance. 3rd ed. oxford, UK: Wiley-Blackwell; 2011.  Back to cited text no. 4
    
5.
Shimizu Y, Kawashiri SY, Noguchi Y, Nagata Y, Maeda T, Hayashida N. Normal range of anti-thyroid peroxidase antibody (TPO-Ab) and atherosclerosis among eu-thyroid population: A cross-sectional study. Medicine (Baltimore) 2020;99:e22214.  Back to cited text no. 5
    
6.
H&E Staining Method and Protocol – Harris; 2011. Available from: http://www.ihcworld.com/_protocols/special_stains/HE_Harris.htm. [Last accessed on 2021 Jan 10].  Back to cited text no. 6
    
7.
World Health Organization. A Guide to Implementation of the WHO Multimodal HH Improvement Strategy; 2009a. Available from: http://www.who.int/gpsc/5may/Guide_to_Implementation.pdf. [Last accessed on 2020 Oct 24].  Back to cited text no. 7
    
8.
World Health Organization. Guide to implementation of the WHO multimodal hand hygiene improvement strategy (revised August 2009).WHO tools for evaluation andfeedback, available online at: http://www.who.int/gpsc/5may/tools/evaluation_feedback/en/. [Last accessed on 2019 Sep 11].  Back to cited text no. 8
    



 
 
    Tables

  [Table 1], [Table 2]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Abstract
Introduction
Materials and Me...
Results
Discussion
Conclusion
References
Article Tables

 Article Access Statistics
    Viewed711    
    Printed1    
    Emailed0    
    PDF Downloaded60    
    Comments [Add]    

Recommend this journal