Hand Hygiene Compliance at Two Tertiary Hospitals in Freetown, Sierra Leone, in 2021: A Cross-Sectional Study

Gladys Nanilla Kamara, Stephen Sevalie, Bailah Molleh, Zikan Koroma, Christiana Kallon, Anna Maruta, Ibrahim Franklyn Kamara, Joseph Sam Kanu, Julian S. O. Campbell, Hemant Deepak Shewade, Saskia van Henten and Anthony D. Harries
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Gladys Nanilla Kamara: Joint Medical Unit, Ministry of Defence, Republic of Sierra Leone Armed Forces, Freetown 00232, Sierra Leone
Stephen Sevalie: Joint Medical Unit, Ministry of Defence, Republic of Sierra Leone Armed Forces, Freetown 00232, Sierra Leone
Bailah Molleh: Department of Clinical Research, Sustainable Health Systems, 34 Military Hospital Research Center, Freetown 00232, Sierra Leone
Zikan Koroma: Department of Laboratory, Diagnostics and Blood Services, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone
Christiana Kallon: Infection Prevention and Control Unit, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone
Anna Maruta: Infection Prevention and Control, World Health Organization Country Office, Freetown 00232, Sierra Leone
Ibrahim Franklyn Kamara: Infection Prevention and Control, World Health Organization Country Office, Freetown 00232, Sierra Leone
Joseph Sam Kanu: Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone
Julian S. O. Campbell: Ola During Children’s Hospital (ODCH) and Princess Christian Maternity Hospital (PCMH) Laboratory, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone
Hemant Deepak Shewade: Division of Health System Research, ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai 600077, India
Saskia van Henten: Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
Anthony D. Harries: Centre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), 75001 Paris, France

IJERPH, 2022, vol. 19, issue 5, 1-11

Abstract: Hand hygiene actions are essential to reduce healthcare-associated infections and the development of antimicrobial resistance. In this cross-sectional study at two tertiary hospitals, Freetown, Sierra Leone, we observed hand hygiene compliance (defined as using handwash with soap and water or alcohol-based hand rub (ABHR) amongst healthcare workers between June and August 2021. Using the WHO Hand Hygiene tool, observations were made in relation to the type of opportunity, different wards and types of healthcare worker. Overall, 10,461 opportunities for hand hygiene were observed, of which 5086 (49%) resulted in hand hygiene actions. ABHR was used more often than handwash (26% versus 23%, p < 0.001). Overall, compliance was significantly better: after being with a patient/doing a procedure than before (78% after body fluid exposure risk compared with 24% before touching a patient— p < 0.001); in Paediatric (61%) compared with Medical wards (46%)— p < 0.001; and amongst nurses (52%) compared with doctors (44%)— p < 0.001. Similar patterns of compliance were observed within each hospital. In summary, hand hygiene compliance was sub-optimal, especially before being with a patient or before clean/aseptic procedures. Improvement is needed through locally adapted training, hand hygiene reminders in wards and outpatient departments, uninterrupted provision of ABHR and innovative ways to change behaviour.

Keywords: hand hygiene compliance; hand hygiene opportunities; Sierra Leone; alcohol-based hand rub; WHO hand hygiene standard observation tool; SORT IT; infection prevention control; hospital-acquired infections; operational research; AMR (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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