The World Health Organization and the Centers for Disease Control and Prevention (CDC) have established guidelines recommending the performance of hand hygiene routines for healthcare workers following glove removal. However, the completion of frequent hygiene routines can cause allergic and adverse skin reactions. This double-blind, randomized study aimed to address this concern by developing and evaluating a modified glove removal technique that minimizes contamination risk during routine phlebotomy procedures. Furthermore, this study used fluorescent detection to compare the frequency of contamination associated with the CDC-recommended technique and the modified technique using fluorescent detection. One hundred healthcare personnel were enrolled and divided into two groups: one group followed the CDC technique, while the other group implemented the modified technique. Participants received instructional videos and practiced under supervision. They subsequently performed blood collection using a simulation arm covered with fluorescent cream as a contamination marker. After removing gloves, hand contamination was assessed under a black light. The median time required for glove removal in the modified group was four seconds longer than that in the group that followed the CDC technique (p < 0.001). Contamination was observed in 2% (1/50) of subjects using the CDC-recommended technique, while no contamination was detected with the modified technique (p ≥ 0.05). Both the group that followed the CDC technique and the group that used modified glove removal techniques demonstrated the potential to prevent contamination during phlebotomy, thereby reducing the need for hand hygiene and the occurrence of contamination and adverse skin reactions. These findings prompt further exploration into whether proper glove removal can reduce the frequency of completing a hand hygiene routine after each glove removal, specifically within the context of phlebotomy. However, it is essential to note that hand hygiene following glove removal is still recommended to prevent contamination. Further research is warranted to validate these findings.

UNASSIGNED: Hand hygiene in health care facilities (HCFs) remains a significant public health challenge. Global baseline estimates on water, Sanitation, and Hygiene (WASH) in HCFs indicate that 26% of HCFs lack access to an improved water source on the premises. In this study, we sought to assess the proportion of handwashing coverage and the associated factors among healthcare workers in public and private healthcare facilities in Ndejje division, Makindye Ssabagabo municipality, Wakiso district.
UNASSIGNED: A descriptive cross-sectional study with both quantitative and qualitative methods of data collection was conducted. A total of 350 healthcare workers were interviewed using a self-administered structured open-ended paper questionnaire and Focus Group Discussions (FGD) guide. Data was analysed using STATA 14.2 and ATLAS. ti version 8 software.
UNASSIGNED: The majority of 350 (92.6%) of healthcare workers were from private health facilities. We found out that the proportion of handwashing facilities coverage was 97.7%. The proportion of handwashing was good coupled with a positive attitude towards handwashing. Being a nurse was highly associated with washing hands in both private and public health facilities.
UNASSIGNED: High hand washing proportion was attributed to the COVID-19 guidelines and enforcement which sparked adherence to the standard operating procedures.

UNASSIGNED: Hand hygiene is recognized as the leading measure to prevent the cross-transmission of microorganisms and to reduce the incidence of healthcare-associated infections.
UNASSIGNED: To assess the knowledge and practice of hygiene among dental health workers even in the wake of Lassa fever.
UNASSIGNED: This questionnaire-based descriptive cross-sectional study was carried out in four public hospitals in Edo state. All data were collected using a self-administered structured questionnaire after obtaining ethical clearance.
UNASSIGNED: 108 of the 120 questionnaires distributed were filled and returned giving a response rate of 90.0%. Overall assessment of respondents\' knowledge of hand hygiene revealed that 41.7% of the respondents possessed a good knowledge of hand hygiene, 37.0% had excellent knowledge, 17.6% had moderate and 3.7% had a weak knowledge of hand hygiene. Overall assessment of the practice of hand hygiene showed that the hand hygiene practice of 58.3% of respondents was fair while 37.0% practiced hand hygiene poorly. Only a few (5.6%) respondents had good hand hygiene practices.
UNASSIGNED: The outbreak of Lassa fever does not seem to positively influence the practice of hand hygiene among the respondents. While knowledge of hand hygiene is satisfactory in this study, the practice still leaves much to be desired.

OBJECTIVE: Our aim was to conduct a thorough comparison between the hand hygiene information included in international nursing textbooks and the Slovenian nursing textbook\'s equivalent content as it relates to nursing procedures.
BACKGROUND: Hand hygiene practices are crucial in preventing healthcare-associated infections, which affect millions of patients annually. The idea behind \"Five Moments for Hand Hygiene\" is to encourage assessing success and boosting self-efficacy.
METHODS: Comparison of hand hygiene content in international nursing textbooks with the content in a Slovenian nursing textbook.
METHODS: A study was conducted between March 2023 and March 2024 to compare hand hygiene content in international nursing textbooks. The study included textbooks from the USA and UK, as well as Slovenian (SI) textbooks. The final phase involved comparing hand hygiene performance practices against the WHO Five Moments for Hand Hygiene.
RESULTS: The study reviewed 470 nursing procedures across three textbooks, identifying four common ones: female indwelling urinary catheterisation, small-bore feeding tube insertion, enema administration and subcutaneous injections. The USA textbook had the highest number of steps, while the UK textbook had the lowest. Clean protective gloves are not recommended for all nursing procedures, only for small-bore feeding tube insertion and enema administration. The US textbook omitted 12 steps for the female indwelling urinary catheter procedure, while the UK textbook included 10 steps. The SI textbook omitted 8 steps.
CONCLUSIONS: Hand hygiene is crucial for healthcare infections prevention and control. The study found differences in the frequency of hand hygiene in these nursing procedures. WHO\'s Five Moments for Hand Hygiene guidelines are not universally accepted, with inadequate hygiene often observed before patient contact. Future research should review foreign textbooks and update existing ones.

BACKGROUND: Undergraduate training in hand hygiene is a keystone of infection control. Several studies have shown overconfidence effects in hand hygiene practices, which can impair metacognition. We hypothesized that overconfidence might be prevalent in the early education stages of nursing students and that these effects could be reduced through frequent interactive learning formats, such as learning groups.
METHODS: We conducted a multicenter cross-sectional questionnaire with 196 German nursing students, including general, surgical, and anesthetic nursing specializations.
RESULTS: Overconfidence was observed in nursing students across all specialties and years of education. The cluster analyses showed three different types of learners: two characterized by overconfidence and one demonstrating justifiable confidence. Furthermore, the moderation analysis indicated that providing feedback and promoting metacognition regarding students\' learning achievements could mitigate overplacement, particularly through the frequent implementation of interactive teaching formats.
CONCLUSIONS: Despite some limitations, these findings highlight the prevalence of overconfidence effects in nursing students, the presence of different learning profiles, and the importance of incorporating feedback within interactive learning formats concerning hand hygiene. Accordingly, educators need to be trained and supervised to deliver these learning formats and provide feedback to students effectively.

BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are among the most epidemiologically relevant health care-associated infections. The aseptic non-touch technique (ANTT) is a standardized practice used to prevent CLABSIs. In a pediatric hospital, the overall CLABSI rate was 1.92/1000 catheter days (CD). However, in one unit, the rate was 5.7/1000 CD.
METHODS: Nurses were trained in ANTT. For the implementation, plan-do-study-act (PDSA) cycles were completed. Adherence monitoring of the ANTT and epidemiological surveillance were performed.
RESULTS: ANTT adherence of 95% was achieved after 6 PDSA cycles. Hand hygiene and general cleaning reached 100% adherence. Port disinfection and material collection had the lowest adherence rates, with 76.2% and 84.7%, respectively. The CLABSI rate decreased from 5.7 to 1.26/1000 CD.
CONCLUSIONS: The implementation of ANTT helped reduce the CLABSI rate. Training and continuous monitoring are key to maintaining ANTT adherence.
UNASSIGNED: Las infecciones relacionadas con catéteres venosos centrales son unas de las infecciones asociadas a la atención de salud con mayor relevancia epidemiológica. La técnica aséptica «no tocar» es una práctica estandarizada que se utiliza para prevenir estas infecciones. En un hospital pediátrico, la tasa de infecciones relacionadas con catéteres venosos centrales fue de 1.92/1000 días de catéter. Sin embargo, en una de las unidades la tasa fue de 5.7/1000 días de catéter.
UNASSIGNED: Se capacitaron enfermeras en la técnica aséptica «no tocar». Para la implementación se cumplieron ciclos de planificar-hacer-estudiar-actuar (PHEA). Se realizaron seguimiento de la adherencia a la técnica y vigilancia epidemiológica.
RESULTS: Se logró una adherencia a la técnica aséptica «no tocar» del 95% después de seis ciclos. La higiene de manos y la limpieza general alcanzaron un 100% de cumplimiento. La desinfección de los puertos y la recolección de material alcanzaron la menor adherencia, con un 76.2% y un 84.7%, respectivamente. La tasa de infecciones relacionadas con catéteres venosos centrales disminuyó de 5.7 a 1.26 por 1000 días de catéter.
CONCLUSIONS: La implementación de la técnica aséptica «no tocar» ayudó en la reducción de infecciones relacionadas con catéteres venosos centrales. La capacitación y el seguimiento continuo son clave para mantener el cumplimiento de la técnica.

Background/Objectives: Hand hygiene (HH) is pivotal in mitigating infectious disease transmission and enhancing public health outcomes. This study focuses on detailing the national surveillance system for alcohol-based hand rub (ABHR) consumption in healthcare facilities across Italy, presenting results from a comprehensive three-year evaluation period, from 2020 to 2022. It aims to delineate this surveillance system and report on ABHR consumption trends in various Regions/Autonomous Provinces (Rs/APs). Methods: ABHR consumption data, collected through the ABHR Italian national surveillance system, coordinated by the Istituto Superiore di Sanità (ISS), were analyzed. Statistical methods, e.g., the Mann-Whitney test, were used to assess trends in ABHR consumption, expressed in liters per 1000 patient days (L/1000PD). Results: The results show significant variation in ABHR consumption across Rs/APs and over the years studied. National median ABHR consumption decreased from 2020 to 2022, with a significant reduction from a median of 24.5 L/1000PD in 2020 to 20.4 L/1000PD in 2021 and 15.6 L/1000PD in 2022. Conclusions: The decline in ABHR consumption raises concerns about the ongoing adherence to HH practices in Italian healthcare settings. This underscores the essential role that systematic ABHR monitoring and improved surveillance play in enhancing HH compliance, suggesting that sustained and strategic efforts are fundamental to uphold high standards of hygiene and to effectively respond to fluctuating ABHR usage trends over time. Further research is needed to explore barriers to effective ABHR use and to develop targeted strategies to improve HH practices.

OBJECTIVE: To evaluate whether the costs of a successful tailored multifaceted strategy to improve hand hygiene compliance outweighed the savings by reducing infection costs in Dutch long-term care facilities (LTCFs).
METHODS: A retrospective cost analysis alongside a stepped-wedge cluster-randomized controlled trial.
METHODS: The study included 14 LTCFs (23 wards) in the Netherlands.
METHODS: The cost analysis was based on the costs of the intervention vs the savings from avoided infections and associated treatment costs. Infection-related costs of the \"usual-care\" period were compared with the combined infection-related costs and intervention costs from the \"intervention\" period and the costs in the \"post-intervention period.\" Multilevel analyses, with a linear model with periods as fixed effects, random effects for cluster LTCFs, and fixed effects for each step, were completed.
RESULTS: There are no significant differences in total costs considering the 3 periods. When adjusting for time and clustering, the mean infection-related costs per week per LTCF for all the infections combined were highest during \"usual-care\" before the hand hygiene intervention was performed, namely 680 euros per week. Assuming the effect of the improvement strategy would be present for 12 months, the costs per week in the \"intervention\" and \"post-intervention\" periods were 627 euros (95% CI, 383-871) and 731 euros (95% CI, 508-954), respectively. Assuming the effect of the improvement strategy will last longer than 1 year (ie, 18 and 24 months), the average cost for the \"intervention period\" and the \"post-intervention\" period decreased to 615 euros and 719 euros during the intervention and 609 euros and 715 euros after the intervention, respectively.
CONCLUSIONS: Our multifaceted hand hygiene improvement strategy achieves cost savings. The results of our study are the first of an economic analysis of a hand hygiene improvement strategy in LTCFs. The results need to be confirmed by further economic evaluations.

BACKGROUND: Hygienic behavior as such belongs to health behavior, acquired at home, at school, at workplace or through the mass-media.
OBJECTIVE: The aim of the study was to analyze the perception of personal hygiene among different age groups and the sociodemographic factors related to hygiene behavior.
METHODS: The author\'s questionnaire for children and seniors concerning selected hygienic behavior was used. The questionnaire was conducted in two groups: 200 primary school children in age: 8-11 years; 109 girls and 91 boys and 200 older people: young-old (60-74 years) and old-old (75+); 110 women and 90 men.
RESULTS: Girls longer than boys take morning hygiene behavior, but statistically boys spend more time on evening washing, cleaning and brushing. Seniors hygienic behavior depend on age: young-old are more likely take a shower every day (51.79%) than seniors in the old-old group (29.86%). The same statistically significant difference was noticed in case of washing hands before a meal.
CONCLUSIONS: Children care more about personal hygiene than older people. Age, not gender, is a factor determining the frequency of hygiene practices among older people. Young-old care more about personal hygiene than old-old.
UNASSIGNED: Zachowania higieniczne należą do zachowań zdrowotnych nabywanych w domu, szkole, miejscu pracy lub za pośrednictwem środków masowego przekazu.
UNASSIGNED: Celem pracy była analiza postrzegania higieny osobistej w różnych grupach wiekowych oraz czynników socjodemograficznych związanych z zachowaniami higienicznymi.
UNASSIGNED: Zastosowano autorską ankietę dla dzieci i seniorów dotyczącą wybranych zachowań higienicznych. Badanie przeprowadzono w dwóch grupach: 200 dzieci ze szkół podstawowych w wieku 8-11 lat;109 dziewcząt, 91 chłopców oraz 200 osób starszych: młodszych starszych (60-74 lat) i starszych starszych (75-89); 110 kobiet i 90 mężczyzn.
UNASSIGNED: Dziewczęta dłużej niż chłopcy przestrzegają porannych zasad higieny, jednak statystycznie chłopcy spędzają więcej czasu na wieczornym myciu i szczotkowaniu zębów. Zachowania higieniczne seniorów zależą od wieku: młodsi starsi częściej biorą prysznic codziennie (51,79%) niż starsi starsi (29,86%). Tę samą różnicę istotną statystycznie zaobserwowano w przypadku mycia rąk przed posiłkiem.
UNASSIGNED: Dzieci bardziej niż osoby starsze dbają o higienę osobistą. Wiek jest czynnikiem determinującym częstotliwość wykonywania praktyk higienicznych wśród osób starszych. Dbanie o higienę osobistą jest na niewystarczającym poziomie, zarówno wśród dzieci w wieku szkolnym, jak i osób powyżej 60 roku życia. Treści programowe realizowane na przedmiocie edukacja zdrowotna powinny zostać uzupełnione o problematykę z zakresu zachowań higienicznych.

Hand hygiene among anesthesia personnel is important to prevent hospital-acquired infections in operating rooms; however, an efficient monitoring system remains elusive. In this study, we leverage a deep learning approach based on operating room videos to detect alcohol-based hand hygiene actions of anesthesia providers. Videos were collected over a period of four months from November, 2018 to February, 2019, at a single operating room. Additional data was simulated and added to it. The proposed algorithm utilized a two-dimensional (2D) and three-dimensional (3D) convolutional neural networks (CNNs), sequentially. First, multi-person of the anesthesia personnel appearing in the target OR video were detected per image frame using the pre-trained 2D CNNs. Following this, each image frame detection of multi-person was linked and transmitted to a 3D CNNs to classify hand hygiene action. Optical flow was calculated and utilized as an additional input modality. Accuracy, sensitivity and specificity were evaluated hand hygiene detection. Evaluations of the binary classification of hand-hygiene actions revealed an accuracy of 0.88, a sensitivity of 0.78, a specificity of 0.93, and an area under the operating curve (AUC) of 0.91. A 3D CNN-based algorithm was developed for the detection of hand hygiene action. The deep learning approach has the potential to be applied in practical clinical scenarios providing continuous surveillance in a cost-effective way.