Compliance With Hand-Washing Guidelines Among Visitors From the Community to Acute Care Settings: A Scoping Review

Exploring factors influencing the compliance of patients and family carers with infection prevention and control recommendations across Bangladesh, Indonesia, and South Korea

Background

Poor compliance with infection prevention and control (IPC) measures has been a longstanding issue globally. To date, healthcare workers (HCWs) have been the primary target for policy and strategy revisions. Recent studies exploring the contributing factors to the spread of COVID-19 across countries in Asia have suggested that the scope of focus should be extended to family carers who provide patient care activities. This study aimed to explore factors affecting patients' and their family carers' IPC compliance in hospitals in Bangladesh, Indonesia, and South Korea.

Method

A qualitative study incorporating 57 semi-structured interviews was conducted in five tertiary-level hospitals across the three focus countries between July 2019 and February 2020. Interviews were undertaken with: (1) patients, family carers and private carers; and (2) healthcare workers, including nurses, doctors, and hospital managers. Drawing upon the principles of grounded theory, data were inductively analyzed using thematic analysis.

Results

A total of three main themes and eight subthemes are identified. Key themes focused on the assumptions made by healthcare workers regarding the family/private carers' level of understanding about IPC and training received; uncertainty and miscommunication regarding the roles of family/private carers; variations in carer knowledge toward IPC and healthcare-associated infections, and the impact of cultural values and social norms.

Conclusion

This exploratory study offers novel findings regarding the factors influencing IPC compliance among patients and their family/private carers across various cultural settings, irrespective of resource availability. The role of cultural values and social norms and their impact on IPC compliance must be acknowledged when updating or revising IPC policies and guidelines.

A new approach to infection prevention: A pilot study to evaluate a hand hygiene ambassador program in hospitals and clinics

BACKGROUND

A pilot study was conducted to assess the perceptions of visitors, patients, and staff to the presence of a hand hygiene ambassador (HHA).

METHODS

Two hundred and twenty-five entrants to various health care settings were surveyed. Only entrants who failed to clean their hands at the alcohol-based handrub (ABHR) station on entry to the lobby were offered application of ABHR by an HHA. Several questions were also asked to assess their attitudes about the presence of an HHA.

RESULTS

When asked whether they think it is a good idea to have an HHA place ABHR on an entrant's hands, the majority of staff, visitors, and patients agreed. No one refused administration of handrub by the HHA.

DISCUSSION

HHA programs have direct and indirect benefits. Although the cost of such an initiative should be considered prior to implementation, it should be weighed against the annual spending for health care-associated infections.

CONCLUSIONS

Considering that hand hygiene compliance and health care-associated infection are clearly linked, a new approach using an HHA may help reduce infection, acting as a source of hand hygiene on entry to the hospital and possibly as a reminder to perform hand hygiene elsewhere in the hospital and clinics.