Keywords
Mobile phones
Stethoscopes
Hands
Aprons
Hygiene practices
COVID-19
Abstract
Background – Healthcare workers’ (HCW) hands and personnel belongings are vehicles of transmission of nosocomial infections. Knowledge, attitude and practice of hand hygiene have been extensively studied suggesting adequate knowledge but poor compliance. Similar data on aprons, mobile phone and stethoscope disinfection practices are lacking. This becomes extensively important topic of discussion in current COVID 19 pandemic where inadequacy in hygiene practices is devastating. Aim– To study the knowledge, attitude and infection prevention practices of HCWs aprons, electronic devices, stethoscopes, and hands. Methods– A cross sectional questionnaire-based survey was conducted among HCWs of Medicine ward and ICU. Findings – Sixty-six HCWs responded to the survey. Awareness that hands, aprons, mobile phones, stethoscopes could cause cross transmission and knowledge of correct practices was present in majority of the respondents. Hand hygiene was performed by 65.2% of the respondents before touching a patient and 54.5% after touching the patient surroundings while 13.6% performed only when it was visibly soiled. Mobile phones and stethoscopes were disinfected by 13.6% and 30.3% of the respondents after each patient encounter, respectively. Aprons were washed after using them at a stretch for a median duration of 5 days (1 – 30 days). Forgetfulness, lack of reinforcement, lack of time, inadequate awareness on standard disinfection practices and fear of damaging electronic devices from disinfectants use were reasons for poor compliance. Conclusion –There is an urgent need to spread awareness and formulate standard guidelines on disinfection practices especially for mobile phones, stethoscopes, and aprons in addition to reinforcing hand hygiene practices.
References
2. Choudhuri AH, Chakravarty M, Uppal R. Epidemiology and characteristics of nosocomial infections in critically ill patients in a tertiary care Intensive Care Unit of Northern India. Saudi J Anaesth. Medknow Publications & Media Pvt Ltd; 2017;11:402–7.
3. Khodavaisy S, Nabili M, Davari B, Vahedi M. Evaluation of bacterial and fungal contamination in the health care workers’ hands and rings in the intensive care unit. Journal of Preventive Medicine and Hygiene. 2011;52:215–8.
4. Brunetti L, De Caro F, Boccia G, Cavallo P, Capunzo M. Surveillance of nosocomial infections: a preliminary study on yeast carriage on hands of healthcare workers. Journal of Preventive Medicine and Hygiene. 2008;49:63–8.
5. Shermil S, VP S, Shamsudeen S, Jamsher M. Identification of Microbial Isolations from the Clinical Aprons of Graduates and Post-Graduate Trainees in a College Department. Acta Scientific Dental Sciences. 2018;8–15.
6. Chauhan A, Garg S, Ranjan A, Singh D, Dimri A, Jindal T. Prevalence of microbial contamination of mobile cell phones in general population of Delhi, India. Journal of Experimental and Clinical Microbiology. 2018;1:12–5.
7. Reihaneh Hosseini Fard, Raziyeh Hosseini Fard, Mohammad Moradi, Maryam Alsadat Hashemipour. Evaluation of the Cell Phone Microbial Contamination in Dental and Engineering Schools: Effect of Antibacterial Spray. Journal of Epidemiology and Global Health. 2018;8:143–8.
8. Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. The Lancet. Elsevier; 2000;356:1307–12.
9. Guinto CH, Bottone EJ, Raffalli JT, Montecalvo MA, Wormser GP. Evaluation of dedicated stethoscopes as a potential source of nosocomial pathogens. American journal of infection control. 2002;30:499–502.
10. Zachary K, Bayne P, Morrison V, Ford D, Silver L, Hooper D. Contamination of gowns, gloves, and stethoscopes with vancomycin-resistant enterococci. Infection control and hospital epidemiology. 2001;22:560–4.
11. Geberemariyam B. Instrument processing knowledge and practice amongst healthcare workers in Addis Ababa, Ethiopia. International Journal of Infection Control. 2018;14.
12. Crofton CC, Foley SJ. An investigation of radiographers’ mobile phone use and the success of an awareness campaign at reducing the nosocomial infection risks. Radiography. Elsevier; 2018;24:57–63.
13. Fatma Ulger, Ahmet Dilek, Saban Esen, Mustafa Sunbul, Hakan Leblebicioglu. Are healthcare workers’ mobile phones a potential source of nosocomial infections? Review of the literature. J Infect Dev Ctries [Internet]. 2015 [cited 2020 May 25];9. Available from: https://jidc.org/index.php/journal/article/view/26517478
14. Nair SS, Hanumantappa R, Hiremath SG, Siraj MA, Raghunath P. Knowledge, Attitude, and Practice of Hand Hygiene among Medical and Nursing Students at a Tertiary Health Care Centre in Raichur, India. Usonis V, Fatmi Z, Trajman A, Parneix P, editors. ISRN Preventive Medicine. Hindawi Publishing Corporation; 2014;2014:608927.
15. Nabavi M, Alavi-Moghaddam M, Gachkar L, Moeinian M. Knowledge, Attitudes, and Practices Study on Hand Hygiene Among Imam Hossein Hospital’s Residents in 2013. Iran Red Crescent Med J. Kowsar; 2015;17:e19606–e19606.
16. van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. Massachusetts Medical Society; 2020;382:1564–7.
17. Adegboye MB, Zakari S, Ahmed BA, Olufemi GH. Knowledge, awareness and practice of infection control by health care workers in the intensive care units of a tertiary hospital in Nigeria. Afr Health Sci. Makerere Medical School; 2018;18:72–8.
18. Al Saleh S, Al Rammah Aidah A-A, Syed W, Al Duhailan R, Kattan S, Al-Mana F. Stethoscope hygiene and barriers among physicians – A cross-sectional study from National Guard Health Affairs in Dammam, Saudi Arabia. Journal of Patient Safety and Infection Control. 2019;7:53–8.
19. Ghumman G, Ahmad N, Pop-Vicas A, Iftikhar S. Stethoscope Cleaning During Patient Care. R I Med J (2013). 2018;101:18–20.
20. Sahiledengle B. Stethoscope disinfection is rarely done in Ethiopia: What are the associated factors? PLoS One. Public Library of Science; 2019;14:e0208365–e0208365.
21. Hand Hygiene: Why, How & When? [Internet]. Available from: https://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf
22. Gammon J, Morgan-Samuel H, Gould D. A review of the evidence for suboptimal compliance of healthcare practitioners to standard/universal infection control precautions. Journal of Clinical Nursing. John Wiley & Sons, Ltd; 2008;17:157–67.
23. Larson E, Killien M. Factors influencing handwashing behavior of patient care personnel. American Journal of Infection Control. Elsevier; 1982;10:93–9.
24. Kirk J, Kendall A, Marx JF, Pincock T, Young E, Hughes JM, et al. Point of care hand hygiene—where’s the rub? A survey of US and Canadian health care workers’ knowledge, attitudes, and practices. American Journal of Infection Control. Elsevier; 2016;44:1095–101.
25. Mark D, Leonard C, Breen H, Graydon R, O’Gorman C, Kirk S. Mobile phones in clinical practice: reducing the risk of bacterial contamination. International Journal of Clinical Practice. John Wiley & Sons, Ltd; 2014;68:1060–4.
26. Panigrahi SK, Pathak VK, Kumar MM, Raj U, Priya P K. Covid-19 and mobile phone hygiene in healthcare settings. BMJ Global Health. 2020;5:e002505.
27. The Wall Street Journal. Should you clean your phone to combat coronavirus? Definitely. Maybe [Internet]. Available from: https://www.wsj.com/articles/should-you-clean-your-phone-to-combat-coronavirus-definitely-maybe-11584018237
28. Apple Support. Cleaning your iPhone. [Internet]. Available from: https://support.apple.com/en-in/HT207123
29. Samsung Support NZ. Galaxy note 8: how to clean dirty glass/screen? [Internet]. Available from: https://www.samsung.com/nz/support/mobile-devices/galaxy-note-8-how-to-clean-dirty-glass-screen/
30. Zúniga A, Mañalich J, Cortés R. [Stethoscope or staphyloscope?: Potential vector in nosocomial infections]. Revista chilena de infectologia : organo oficial de la Sociedad Chilena de Infectologia. 2016;33:19–25.
31. Marinella MA. COVID-19 pandemic and the stethoscope: Do not forget to sanitize. Heart Lung. 2020/04/11 ed. Elsevier Inc.; 2020;49:350–350.
32. Abd Elaziz K, Bakr I. Assessment of knowledge, attitude and practice of hand washing among health care workers in Ain Shams University hospitals in Cairo. Journal of preventive medicine and hygiene. 2009;50:19–25.
33. Salemi C, Canola M, Eck E. Hand washing and physicians: how to get them together. Infect Control Hosp Epidemiol. 2002;23:32–5.