Journal of Patient Safety and Infection Control

PERSPECTIVE
Year
: 2020  |  Volume : 8  |  Issue : 2  |  Page : 37--38

Audit on hand hygiene and use of personal protective equipment: Prevention of nosocomial transmission of COVID-19


Indranath Roy 
 Microbiologist, Intermediate Reference Laboratory, Kolkata, State TB Division, Department of Health and Family Welfare, Government of West Bengal, India

Correspondence Address:
Dr. Indranath Roy
1/B, Surji Dutta Lane, Kolkata - 700 006, West Bengal
India




How to cite this article:
Roy I. Audit on hand hygiene and use of personal protective equipment: Prevention of nosocomial transmission of COVID-19.J Patient Saf Infect Control 2020;8:37-38


How to cite this URL:
Roy I. Audit on hand hygiene and use of personal protective equipment: Prevention of nosocomial transmission of COVID-19. J Patient Saf Infect Control [serial online] 2020 [cited 2021 Jan 19 ];8:37-38
Available from: https://www.jpsiconline.com/text.asp?2020/8/2/37/304212


Full Text



Since December 2019, all over the world, the COVID-19 pandemic has been causing significant loss of life, disrupting livelihoods and threatening the recent advances in health. This pandemic has de-accelerated progress towards the global development goals highlighted in the 2020 World Health Statistics published by the World Health Organization (WHO). The pandemic has highlighted the urgent need for all countries to invest in strong health systems and primary healthcare, which has been regarded as the best defence against outbreaks like COVID-19, and against many other health threats that people around the world face every day.

There has been a tremendous pressure on health infrastructure for this unexpected rapid spread of this SARS-CoV-2 across the globe. There has been an unprecedented demand of personal protective equipment (PPE) almost in every frontline healthcare facility fighting against the coronavirus. Every healthcare authority is also trying to provide adequate supply of PPE to the frontline warriors in this battle.[1]

One thing which is very important to be acknowledged by healthcare authorities that mere use of PPE cannot ensure the removal or reduction of the risk of acquired infection amongst the healthcare workers (HCWs); moreover, there is every possibility of nosocomial transmission of the coronavirus due to improper use of PPE.[2] Poor compliance to hand hygiene (HH) has added the extra burden to this problem.

Without a proper training and knowledge of PPE use, it could be detrimental to the HCWs and also for the patients. Donning and doffing of PPE needs regular training, and we cannot expect that evertime HCWs will use the PPE in right way even when there has been a emergency situation.[3]

Not only regular training of PPE use and HH by HCWs but also audit on infection prevention and control (IPC) practices at regular intervals in any healthcare facility is utmost important.[4]

Health authorities can understand the scenario by conducting audit and that will guide them to identify the loopholes in the regular practice of HH and PPE use, which enable them to take right policy to implement proper IPC programme amongst the HCWs.

I would like to emphasise on two key issues on basic IPC programme: one has been HH and the other proper use of PPE.

There are different audit mythodologies on the both which could be implemented even in the present scenario. These audits would help to reduce not only the risk of acquiring and further transmitting COVID-19 but also the irrational use of PPE.

In the case of HH, health authorities can follow the compliance rate based on the WHO's five moments of HH protocol.

In the case of PPE usage, the audit process could be divided into, firstly, PPE selection by HCWs based on the anticipated risk of exposure and secondly, on proper sequence of donning and doffing.

If these audits are conducted in a manner of pre-sensitisation and post-sensitisation of IPC training programme, obviously there will be a good reflection of their performances in daily practices.

Every healthcare authority should involve his/her HCWs in audits, which is always considered a nobel approach for identifying the HH compliance rate and PPE knowledge. Good compliance to HH and adequate knowledge of PPE obviously will reduce the possibility of nosocomial transmission of COVID-19. Moreover, inadequate training of HH and poor PPE knowledge could endanger not only HCWs but also patients and the environment.[5]

I would like to mention that excellent compliance of HH and good knowledge of PPE could not be achieved in one day. It requires continuous training, mock drill and audit to improve the performance. Hence, continuous training, mock drill and audit on IPC programmes could be highly beneficial to all healthcare facilities in order to achieve an excellent healthcare service with observable reduction of risk of nosocomial transmission of COVID-19.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Kang J, O'Donnell JM, Colaianne B, Bircher N, Ren D, Smith KJ. Use of personal protective equipment among health care personnel: Results of clinical observations and simulations. Am J Infect Control 2017;45:17-23.
2Beam EL, Schwedhelm S, Boulter K, Kratochvil C, Lowe J, Hewlett A, et al. Personal protective equipment processes and rationale for the Nebraska Biocontainment Unit during the 2014 activations for Ebola virus disease. Am J Infect Control 2016;44:340-2.
3Harrod M, Weston LE, Gregory L, Petersen L, Mayer J, Drews FA, et al. A qualitative study of factors affecting personal protective equipment use among health care personnel. Am J Infect Control 2020;48:410-5.
4World Health Organization. Infection Prevention and Control During Health Care when Novel Coronavirus (nCoV) Infection is Suspected. Interim Guidance. Geneva: World Health Organization; 2020.
5Laskar AM, Deepashree R, Bhat P, Pottakkat B, Narayan S, Sastry AS, et al. A multimodal intervention to improve hand hygiene compliance in a tertiary care center. Am J Infect Control 2018;46:775-80.