Hand hygiene compliance of healthcare workers before and during the COVID-19 pandemic: A long-term follow-up study

Stangerup, Marie; Hansen, Marco Bo; Hansen, Rosa; Sode, Louise Palasin; Hesselbo, Bjørn; Kostadinov, Krassimir; Olesen, Bente Scharvik; Calum, Henrik

BACKGROUND: :Information about the long-term effects of hand hygiene (HH) interventions is needed. We aimed to investigate the change in HH compliance (HHC) of healthcare workers (HCWs) once a data-driven feedback intervention was stopped, and to assess if the COVID-19 pandemic influenced the HH behavior. METHODS: :We conducted an observational, extension trial in a surgical department between January 2019–December 2020. Doctors (n=19) and nurses (n=53) were included and their HHC was measured using an electronic HH monitoring system (EHHMS). We compared the changes in HHC during three phases: 1) Intervention (data presentation meetings), 2) Pre-pandemic follow-up and 3) Follow-up during COVID-19. SOURCE OF FUNDING: : This study was partly funded by the Danish Ministry of Health (J. no. 1608966). CONFLICT OF INTEREST: MBH is working in Konduto ApS which has developed sani nudge(TM). The other authors declare that they have no competing interests. All authors have approved the final article. RESULTS: :The HHC during phase 1 (intervention), phase 2 (pre-pandemic follow-up) and phase 3 (follow-up during COVID-19) was 58%, 46%, and 34%, respectively. Comparison analyses revealed that the HHC was significantly lower in the pre-pandemic follow-up period (46% vs 58%, P<.0001) and in the follow-up period during COVID-19 (34% vs 58%, P<.0001) compared with the intervention period (phase 1). CONCLUSIONS: :Despite the COVID-19 pandemic, the HHC of the HCWs significantly decreased over time once the data presentation meetings from management stopped. This study demonstrates that HCWs fall back into old HH routines once improvement initiatives are stopped.