BACKGROUND: Good hand hygiene techniques (HHTs), like those of the World Health Organization (WHO), prevent microbial contamination of aseptic preparations. The objective of this study was to assess the efficacy of a game-based training (GBT) tool (the Handtastic Box) to improve the compliance of hospital pharmacy operators (HPOs) with handwashing guidelines.
METHODS: A camera recorded handwashing by HPOs for 1 month before the training day, for 1 month after the training day (M1), and between month 1 and month 3 (M2&3). Movements were scored as fully executed, partially executed or not executed. Compliance rates of each HPO with HHTs were compared between observation periods. During 1-h training sessions, pairs of HPO trainees watched handwashing videos and noted which of five guideline steps was missing. They examined wooden hands with areas stained with fluorescein under ultraviolet light to find the hand showing the matching contamination.
RESULTS: The mean compliance score for nine HPOs increased from 44.6% (before training, N=32 videos) to 86.7% (M1, N=40) to 82.5% (M2&3, N=45). Compliance with every step improved from before training to M1 and generally stabilized in M2&3, except for the fingertip washing step which dropped significantly in M2&3.
CONCLUSIONS: To the authors\' knowledge, this is the first study to assess the efficacy of a GBT tool to improve HPO compliance with the WHO HHTs. The tool improved handwashing scores significantly, and maintained them at the same level for 3 months after training. The separate results for each step highlight the need to train every movement.
CONCLUSIONS: This GBT tool successfully improved compliance with the WHO HHTs for 3 months. This training could be used for other healthcare professionals.

The objective of the project was to identify new strategies, agreed upon by experts, that help reduce the prevalence of Health Care Related Infections (HAIs) given the increase in their prevalence as a result of the pandemic and improve patient safety.
The project was developed in three phases. The first two are framed in a sequential explanatory mixed model. Phase 1 consisted of a quantitative study (anonymous survey) to find out the perception of healthcare professionals about HAIs, risk factors, preventive measures, protocols, disinfection products and approaches. Phase 2 consisted of a qualitative exploratory study in which a panel of 15 experts analyzed the results, using focus group techniques, integrating both phases through the elaboration of metainferences. Phase 3 consisted of a qualitative descriptive study where, through nominal group techniques, agreed proposals for strategies to prevent HAIs were prepared.
The panel of experts defined a total of 51 proposals for new strategies: 15 in hand hygiene, 13 in surface cleaning, 13 in the use of devices, and 10 in HAI prevention training. Of all of them, 13 were agreed upon as preferable (medium-high viability and high impact) and 7 as recommendable (low viability and high impact).
In the prevention of HAIs, experts recommend applying different strategies simultaneously, which include innovative, technological and humanization aspects, both in data collection, intervention and training, prioritizing those with the greatest impact. and feasibility.

BACKGROUND: Healthcare-associated infections are often associated with poor hand hygiene (HH) by healthcare workers (HCWs). The objective of this cross-sectional study at the Umberto I teaching hospital in Rome was to quantify compliance with HH by direct observation following a multimodal strategy devised by the World Health Organisation and to map critical areas for improvement.
METHODS: Predictors of HH compliance were identified using a multivariable logistic regression model. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated.
RESULTS: Eighty-four trained observers from 50 wards collected 4,081 observations showing that overall HH compliance was 71.9%. The multivariable analysis found a positive association with the outcome for midwives compared to physicians (aOR=2.5, 95% CI: 1.5-4.1), and a negative association for healthcare assistants (aOR=0.5, 95% CI: 0.3-0.8). There was greater compliance during public holidays and weekends (aOR=1.5, 95% CI: 1.1-2.1), but compliance was lower for external staff (aOR=0.7, 95% CI: 0.5-0.9). We found a positive association with all HH indications after interaction with a patient or with patient surroundings compared with the indication \"before touching a patient\" (all p<0.001); the highest association was with the indication \"after contact with biological fluids\" (aOR=7.7, 95% CI: 4.7-12.5).
CONCLUSIONS: Overall, we observed reasonable compliance levels, but it is important to increase adherence to HH practice and monitor any behaviour change.

Effective hand hygiene is an important part of infection prevention, especially in perioperative areas. The revised AORN \"Guideline for hand hygiene\" provides perioperative personnel with evidence-based practice recommendations for hand hygiene. This article presents an overview of the guideline and discusses specific recommendations for maintaining appropriate fingernail and hand condition; wearing or removing hand and wrist jewelry; performing general hand hygiene; performing surgical hand antisepsis with a traditional hand scrub or surgical hand rub; selecting sinks, faucets, and drains to avoid hand contamination; and implementing quality activities to enhance hand hygiene compliance. It also includes a scenario illustrating how nurses can use the guideline to mitigate hand dermatitis associated with surgical hand antisepsis. Perioperative nurses should review the revised guideline in its entirety and apply the recommendations as applicable for their practice.

Hand hygiene is an important measure to prevent disease transmission.
To summarise current international guideline recommendations for hand hygiene in community settings and to assess to what extent they are consistent and evidence based.
We included international guidelines with one or more recommendations on hand hygiene in community settings-categorised as domestic, public or institutional-published by international organisations, in English or French, between 1 January 1990 and 15 November 2021.
To identify relevant guidelines, we searched the WHO Institutional Repository for Information Sharing Database, Google, websites of international organisations, and contacted expert organisations and individuals.
Recommendations were mapped to four areas related to hand hygiene: (1) effective hand hygiene; (2) minimum requirements; (3) behaviour change and (4) government measures. Recommendations were assessed for consistency, concordance and whether supported by evidence.
We identified 51 guidelines containing 923 recommendations published between 1999 and 2021 by multilateral agencies and international non-governmental organisations. Handwashing with soap is consistently recommended as the preferred method for hand hygiene across all community settings. Most guidelines specifically recommend handwashing with plain soap and running water for at least 20 s; single-use paper towels for hand drying; and alcohol-based hand rub (ABHR) as a complement or alternative to handwashing. There are inconsistent and discordant recommendations for water quality for handwashing, affordable and effective alternatives to soap and ABHR, and the design of handwashing stations. There are gaps in recommendations on soap and water quantity, behaviour change approaches and government measures required for effective hand hygiene. Less than 10% of recommendations are supported by any cited evidence.
While current international guidelines consistently recommend handwashing with soap across community settings, there remain gaps in recommendations where clear evidence-based guidance might support more effective policy and investment.

Surgical site infection is the most frequent and avoidable complication of surgery, but clinical guidelines for its prevention are insufficiently followed. We present the results of a Delphi consensus carried out by a panel of experts from 17 Scientific Societies with a critical review of the scientific evidence and international guidelines, to select the measures with the highest degree of evidence and facilitate their implementation. Forty measures were reviewed and 53 recommendations were issued. Ten main measures were prioritized for inclusion in prevention bundles: preoperative shower; correct surgical hand hygiene; no hair removal from the surgical field or removal with electric razors; adequate systemic antibiotic prophylaxis; use of minimally invasive approaches; skin decontamination with alcoholic solutions; maintenance of normothermia; plastic wound protectors-retractors; intraoperative glove change; and change of surgical and auxiliary material before wound closure.

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Despite the development and enforcement of preventive guidelines by governments, COVID-19 continues to spread across nations, causing unprecedented economic losses and mortality. Public places remain hotspots for COVID-19 transmission due to large numbers of people present; however preventive measures are poorly enforced. Supermarkets are among the high-risk establishments due to the high interactions involved, which makes compliance with the COVID-19 preventive guidelines of paramount importance. However, until now, there has been limited evidence on compliance with the set COVID-19 prevention guidelines. Therefore, this study aimed to measure compliance with the COVID-19 prevention guidelines among supermarkets in Kampala Capital City and Mukono Municipality Uganda.
A cross-sectional study was conducted among selected supermarkets in Kampala Capital City and Mukono Municipality in September 2020. A total of 229 supermarkets (195 in Kampala City and 34 in Mukono Municipality) were randomly selected for the study. Data were collected through structured observations on the status of compliance with COVID-19 prevention guidelines, and entered using the KoboCollect software, which was preinstalled on mobile devices (smart phones and tablets). Descriptive statistics were generated to measure compliance to the set COVID-19 Ministry of Health prevention guidelines using Stata 14 software.
Only 16.6% (38/229) of the supermarkets complied with the COVID-19 prevention and control guidelines. In line with the specific measures, almost all supermarkets 95.2% (218/229) had hand washing facilities placed at strategic points such as the entrance, and 59.8% (137/229) of the supermarkets surveyed regularly disinfected commonly touched surfaces. Only 40.6% and 30.6% of the supermarkets enforced mandatory hand washing and use of face masks respectively for all customers accessing the premises. Slightly more than half, 52.4% (120/229) of the supermarkets had someone or a team in charge of enforcing compliance to COVID-19 measures and more than half, 55.5% (127/229) of the supermarkets had not provided their staff with job-specific training/mentorship on infection prevention and control for COVID-19. Less than a third, 26.2% (60/229) of the supermarkets had an infrared temperature gun for screening every customer, and only 5.7% (13/229) of the supermarkets captured details of clients accessing the supermarket as a measure to ease follow-up.
This study revealed low compliance with COVID-19 guidelines, which required mandatory preventive measures such as face masking, regular disinfection, social distancing, and hand hygiene. This study suggests the need for health authorities to strengthen enforcement of these guidelines, and to sensitise the supermarket managers on COVID-19 in order to increase the uptake of the different measures.

Background: We sought to understand the association between heavy alcohol and frequent drug use and non-adherence to recommended social distancing and personal hygiene guidelines for preventing the spread of COVID-19 early in the US pandemic. Methods: A survey was offered on the crowdsourcing platform, Amazon Mechanical Turk (MTurk) during April 2020 (the early days of strict, social distancing restrictions). The study included 1,521 adults ages 18 years and older who resided in the US and were enrolled as MTurk workers, i.e., workers who are qualified by Amazon to complete a range of human interaction tasks, including surveys through the MTurk worker platform. Main predictors included measures of heavy drinking, marijuana, and polysubstance use. The dependent measures were measures of social distancing and personal hygiene, based on guidelines recommended at the time of the survey by the US Centers for Disease Control to prevent the spread of COVID-19. Results: We found consistent negative associations between heavy drinking and drug use and adherence to social distancing and personal hygiene. Additionally, three control variables, age, gender, and race/ethnicity, were significant correlates of adherence to these measures. Conclusions: The findings here are consistent with previous research exploring links between substance use and other adverse health behaviors. Further, the negative association between heavy drinking (five or more drinks in one sitting) and adherence underscore the public health risks entailed with the unrestricted reopening of public drinking establishments.