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

Am J Infect Control. 2021 Sep;49(9):1118-1122. doi: 10.1016/j.ajic.2021.06.014. Epub 2021 Jun 25.


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 3 phases: (1) Intervention (data presentation meetings), (2) Prepandemic follow-up and (3) Follow-up during COVID-19.

Results: The HHC during phase 1 (intervention), phase 2 (prepandemic 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 prepandemic 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.

Keywords: Automated hand-hygiene monitoring; Electronic monitoring systems; Infection prevention and control; Nosocomial; Real-time measurement.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19*
  • Cross Infection* / epidemiology
  • Cross Infection* / prevention & control
  • Follow-Up Studies
  • Guideline Adherence / statistics & numerical data*
  • Hand Hygiene*
  • Health Personnel*
  • Humans
  • Infection Control
  • Pandemics