key: cord-0837923-kg2pg8y2
authors: Wong, S.-C.; AuYeung, C.H.-Y.; Lam, G.K.-M.; Leung, E.Y.-L.; Chan, V.W.-M.; Yuen, K.-Y.; Cheng, V.C.-C.
title: Is it possible to achieve 100 percent hand hygiene compliance during the COVID-19 pandemic?
date: 2020-05-15
journal: J Hosp Infect
DOI: 10.1016/j.jhin.2020.05.016
sha: 68584eb06bb1afa6b12b69a18d3cfe45cf070fea
doc_id: 837923
cord_uid: kg2pg8y2

nan

enforced the practice of the WHO "my five moments for hand hygiene", together with our institutionally-promoted 6 th moment -"hand hygiene before touching your mucous membrane". We continued performing hand hygiene audits according to the WHO protocol. Since the SARS-CoV-2 is predominantly transmitted via droplet and contact routes, hand hygiene with appropriate PPE are key infection control measures to protect HCWs. 2 We therefore expected hand hygiene compliance among our HCWs to increase further during the COVID-19 pandemic. It is unexpected to observe relatively lower hand hygiene compliance among HCWs working in ward B, of which some of the beds are used for caring suspected or confirmed COVID-19 patients. We understand that it may not be realistic to achieve 100% hand hygiene compliance in all units, but lapses in hand hygiene may pose a risk to HCWs, especially during the COVID-19 pandemic. Therefore, we have introduced a buddy system to implement a model of directly-observed degowning (DODG) to minimize the risk of self-contamination. 4 The model of DODG has been taught to all HCWs who require working in AIIRs during our face-to-face training sessions. In this model, the HCW is observed by other colleagues during the degowning procedure.

Hand hygiene, as well as appropriate degowning, are ensured by real-time reminders.

This intervention may be a reason why we have achieved zero nosocomial infection by SARS-CoV-2 among HCWs from the pre-pandemic phase of COVID-19, 5 and until now.

Hand hygiene among HCWs has become even more important in the context of the COVID-19 pandemic, 6 especially with evidence of SARS-CoV-2 transmission while presymptomatic or asymptomatic. 7 Although we have enforced DODG and directlyobserved hand hygiene during the critical moments in patient care practice, 8 leaders' commitment to build up a good hand hygiene culture can protect our HCWs and patients in all circumstances including the COVID-19 pandemic.

We thank our healthcare workers to fight against the COVID-19 pandemic.

Financial support. Pediatric unit A is located in ward A, caring patients with cardiac diseases. Pediatric unit B is located in ward B, caring patients with infectious diseases. Airborne infection isolation rooms are only available in ward B, which is designated for the management of suspected or confirmed COVID-19 patients.

Situation Report -110. World Health Organization

Escalating infection control response to the rapidly evolving epidemiology of the Coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong

Impact of observing hand hygiene in practice and research: a methodological reconsideration

Infection control challenge in setting up a temporary test center at the international airport for rapid diagnosis of coronavirus disease 2019 (COVID-19) due to SARS-CoV-2

Absence of nosocomial transmission of coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in the pre-pandemic phase in Hong Kong

Hand hygiene and the novel coronavirus pandemic: The role of healthcare workers

Evidence supporting transmission of severe acute respiratory syndrome coronavirus 2 while presymptomatic or asymptomatic

Directly observed hand hygienefrom healthcare workers to patients

Hand hygiene compliance among healthcare workers in two paediatric units before and during COVID-19 pandemic

All authors report no conflicts of interest relevant to this article.