Purpose: This study aims to compare surgical scrubbing with and without a brush in decreasing the number of germ colonies on hands. Background: Surgical scrubbing with and without a brush are currently popular worldwide. To date, the optimal method in decreasing the number of germ colonies on the hands is not known. Methods: Systematic review of effectiveness was conducted. The databases and publisher websites included PubMed, Science Direct, Google Scholar, Wiley Online Library, Cochrane Library and recruitment studies published between 2009-2019. The risk of bias was assessed utilizing Cochrane Collaboration's tool. Results: Included clinical studies consisting of five randomized controlled trials. The procedures and duration of surgical scrubbing on each study varied depending on the protocol as a reference. All clinical studies found no difference in the number of colonyforming units (CFU) on the hand between surgical scrubbing with and without a brush. Conclusions Scrubbing with and without a brush showed similar efficacy in terms of the number of germ colonies on the hands.
Hand Disinfection

OBJECTIVE: To investigate the baseline levels of microorganisms' growth on the hands of anesthesiologists and in the anesthesia environment at a cancer hospital. METHODS: This study performed in nine operating rooms and among 25 anesthesiologists at a cancer hospital. Sampling of the hands of anesthesiologists and the anesthesia environment was performed at a ready-to-use operating room before patient contact began and after decontamination. RESULTS: Microorganisms' growth results showed that 20% (5/25) of anesthesiologists' hands carried microorganisms (> 10 CFU/cm ²) before patient contact began. Female anesthesiologists performed hand hygiene better than did their male counterparts, with fewer CFUs ( P = 0.0069) and fewer species ( P = 0.0202). Our study also found that 55.6% (5/9) of ready-to-use operating rooms carried microorganisms (> 5 CFU/cm ²). Microorganisms regrowth began quickly (1 hour) after disinfection, and increased gradually over time, reaching the threshold at 4 hours after disinfection. Staphylococcus aureus was isolated from the hands of 20% (5/25) of anesthesiologists and 33.3% (3/9) of operating rooms. CONCLUSION Our study indicates that male anesthesiologists need to pay more attention to the standard operating procedures and effect evaluation of hand hygiene, daily cleaning rate of the operating room may be insufficient, and we would suggest that there should be a repeat cleaning every four hours.
Female ; Humans ; Male ; Anesthesia ; Anesthesiologists/statistics & numerical data* ; Disinfection/standards* ; Hand Hygiene/statistics & numerical data* ; Staphylococcal Infections ; Operating Rooms/statistics & numerical data* ; Staphylococcus aureus/isolation & purification*

INTRODUCTION: As part of infection control measures for COVID-19, individuals have been encouraged to adopt both preventive (such as handwashing) and avoidant behavioural changes (e.g. avoiding crowds). In this study, we examined whether demographics predicted the likelihood that a person would adopt these behaviours in Singapore. METHODS: A total of 1,145 participants responded to an online survey conducted between 7 March and 21 April 2020. We collected demographic information and asked participants to report which of 17 behaviour changes they had undertaken because of the COVID-19 outbreak. Regression analyses were performed to predict the number of behavioural changes (preventive, avoidant, and total) as a function of demographics. Finally, we sought to identify predictors of persons who declared that they had not undertaken any of these measures following the outbreak. RESULTS: Most participants (97%) reported at least one behavioural change on account of the pandemic, with changes increasing with the number of local COVID-19 cases ( CONCLUSION Our characterisation of behavioural changes provides a baseline for public health advisories. Moving forward, health authorities can focus their efforts on encouraging segments of the population who do not readily adopt infection control measures against COVID-19.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; COVID-19/psychology* ; Female ; Follow-Up Studies ; Hand Disinfection/trends* ; Health Behavior ; Health Policy ; Health Surveys ; Humans ; Male ; Middle Aged ; Pandemics ; Physical Distancing ; Risk-Taking ; Self Report ; Sex Factors ; Singapore/epidemiology* ; Socioeconomic Factors

BACKGROUND: Public perceptions and personal characteristics are heterogeneous between countries and subgroups, which may have different impacts on health-protective behaviors during the coronavirus disease 2019 (COVID-19) pandemic. To assess whether self-reported perceptions of COVID-19 and personal characteristics are associated with protective behaviors among general adults and to compare patterns in six different countries. METHODS: This cross-sectional study uses the secondary data collected through an online survey between 15 and 23 April 2020 across six countries (China, Italy, Japan, Korea, the UK, and the USA). A total of 5945 adults aged 18 years or older were eligible for our analysis. A logistic regression model was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) of three recommended behaviors (wearing a mask, handwashing, and avoiding social gatherings). RESULTS: In most countries except for China, the participants who perceived wearing a mask as being extremely effective to curtail the pandemic were more likely to wear a mask (OR, 95%CI: Italy: 4.14, 2.08-8.02; Japan: 3.59, 1.75-7.30; Korea: 7.89, 1.91-31.63: UK: 9.23, 5.14-17.31; USA: 4.81, 2.61-8.92). Those who perceived that handwashing was extremely effective had higher ORs of this preventive behavior (OR, 95%CI: Italy: 16.39, 3.56-70.18; Japan: 12.24, 4.03-37.35; Korea: 12.41, 2.02-76.39; UK: 18.04, 2.60-152.78; USA: 10.56, 2.21-44.32). The participants who perceived avoiding social gathering as being extremely effective to curtail the pandemic were more likely to take this type of preventive behavior (OR, 95%CI: China: 3.79, 1.28-10.23; Korea: 6.18, 1.77-20.60; UK: 4.45, 1.63-11.63; USA: 4.34, 1.84-9.95). The associations between personal characteristics, living environment, psychological status, and preventive behaviors varied across different countries. Individuals who changed their behavior because of recommendations from doctors/public health officials were more likely to take preventive behaviors in many countries. CONCLUSIONS These findings suggest that higher perceived effectiveness may be a common factor to encourage preventive behaviors in response to the COVID-19 pandemic. These results may provide a better understanding of the homogeneity and heterogeneity of factors related to preventive behaviors and improve public health policies in various countries and groups.
Adolescent ; Adult ; Aged ; Attitude to Health ; COVID-19/psychology* ; Cross-Sectional Studies ; Female ; Hand Disinfection ; Health Behavior ; Humans ; Male ; Masks ; Middle Aged ; Physical Distancing ; SARS-CoV-2 ; Self Report ; Social Conformity ; Young Adult

PURPOSE: This descriptive research was on hand dermatitis in clinical nurses. Nurses often have a high rate of hand dermatitis with several factors associated with the dermatitis. The factors analyzed in this study included; general characteristics, work-related factors, hand washing, and allergies relate to hand dermatitis. METHODS: Data were collected from April to May 2016. The subjects were nurses who had worked 12 months or more in a University Hospital. They voluntarily gave their consent for the research. The Symptombased questionnaires were sent to 220 nurses and 199 responses were returned. Collected data were analyzed using frequency, percentage, mean, standard deviation, χ2-test, and logistic regression analysis using SPSS 23.0. RESULTS: Prevalence of dermatitis in nurses was 48.2%. Nurses who had worked for over three years were twice more likely to suffer hand dermatitis than nurses who had worked for 3 years or less (adjusted odds ratio [adj. OR]=1.97, p=.036). Nurses who used alcohol sponge swabs more than 20 times per shift were 2.5 times more likely to suffer hand dermatitis as compared to those who used them less times (adj. OR=2.51, p=.023). CONCLUSION: Results revealed that about a half of the clinical nurses suffered from hand dermatitis, hence it is crucial to find appropriate interventions for dermatitis prevention. This concern needs to be addressed especially in nurses who have more work experience and use more alcohol sponge swabs.
Dermatitis ; Ethanol ; Hand Disinfection ; Hand ; Hypersensitivity ; Logistic Models ; Odds Ratio ; Porifera ; Prevalence

The most common cause of antibiotic-associated diarrhea is Clostridium difficile infection (CDI). Recurrent C. difficile infection (rCDI) often occurs after successful treatment of CDI. Due to the increased incidence and the difficulty in treating rCDI, it is becoming an important clinical issue. Identifying risk factors is helpful for early detection, treatment, and prevention of rCDI. Advanced age, use of antibiotics, gastric acid suppression, and infection with a hypervirulent strain are currently regarded as the major risk factors for rCDI. Several treatment modalities, including vancomycin, fidaxomicin, and fecal microbiota transplant (FMT), are suggested for rCDI treatment. However, there is currently no definitive treatment method with sufficient evidence for rCDI. Recent studies have focused on FMT and have shown positive results for rCDI. Prevention of rCDI by measures such as hand washing and isolation of patients is very important. However, these preventive measures are often overlooked in clinical practice. Here, we review the risk factors, treatment, and prevention of rCDI.
Anti-Bacterial Agents ; Clostridium difficile* ; Clostridium* ; Diarrhea ; Gastric Acid ; Hand Disinfection ; Humans ; Incidence ; Methods ; Microbiota ; Recurrence ; Risk Factors* ; Vancomycin

PURPOSE: Although dental impression disinfection is determinant to reduce the cross-infection risk, some studies have shown that, in real practice, the disinfection procedures vary considerably. Thus, the aim of this study was to evaluate the antimicrobial effectiveness and the impact on the dimensional stability of addition silicone' impressions of water wash and the most clinically used disinfection solutions: 3% hydrogen peroxide, commercial disinfectant MD520 (Durr) and 1% and 5.25% sodium hypochlorite. MATERIALS AND METHODS: For this investigation, dental impressions were taken on 16 volunteer dental students. The antimicrobial effectiveness of each procedure was evaluated by pour plate method. The dimensional stability was evaluated using a standardized stainless-steel model, according to ANSI/ADA nº19 specification. RESULTS: The study results showed that water wash does not alter the dimensional stability of addition silicone impressions but doesn't reduce the microbial load of the material (P>.05). On the other hand, addition silicone disinfection by immersion with 3% hydrogen peroxide, MD520 (Durr), or sodium hypochlorite at 1% and 5.25% does not alter the dimensional stability significantly but reduces > 99.9% of the microbial load of the impressions (P<.001). CONCLUSION: Addition silicone impressions should always be disinfected after water wash in order to reduce effectively the cross-infection risk. All disinfectants tested showed high antimicrobial efficiency without significant changes in three-dimensional shape of impressions. Hydrogen peroxide and sodium hypochlorite are of particular importance because are easily accessible in dental setting. The less explored hydrogen peroxide could be a valuable alternative for silicone impressions disinfection.
Disinfectants ; Disinfection ; Hand ; Humans ; Hydrogen Peroxide ; Immersion ; Methods ; Silicon ; Silicone Elastomers ; Silicones ; Sodium Hypochlorite ; Students, Dental ; Volunteers ; Water

PURPOSE: A hand-washing program using role-playing was developed for preschool children and tested to verify its usefulness. METHODS: The participants were 46 preschool children (experimental group, 23; control group, 23). Data were collected from August 7, 2017 to September 20, 2017. The first posttest was carried out on the day after the initial intervention was completed, and the second posttest was performed after a month. Data were analyzed using the χ² test, Fisher exact test, Shapiro-Wilk test, Mann-Whitney test, and Friedman test. RESULTS: In the experimental group, the frequency of practicing hand-washing was significantly higher than in the control group on the next day (z=−4.94, p<.001) and after a month (z=−3.15, p=.002). The accuracy of hand-washing was significantly higher in the experimental group than in the control group on the next day (z=−4.02, p<.001) and after a month (z=−3.86, p<.001). CONCLUSION: The hand-washing program developed in this study was found to be an effective intervention strategy for improving the frequency and accuracy of hand-washing among preschool children.
Child ; Child, Preschool ; Hand Disinfection ; Humans ; Role Playing

PURPOSE: The purpose of this study was to explore and describe the meanings of hands among clinical nurses.METHODS: A descriptive qualitative study design was used. Participants were 1,048 nurses working in a tertiary hospital in G city. From April to May 2018, an open-ended survey on how nurses felt about their hands and what their hands meant to them was conducted. The collected data were analyzed using MAXQDA 2018 version as well as content analysis.RESULTS: A total of 1,048 pieces of data were analyzed, and 2,094 units of analysis were categorized based on their attributes, resulting in physical, emotional, and social domains. The data in the social domain were reported in a narrative format; thus, they were analyzed using content analysis. Three themes and eight sub-themes were elicited. The three themes included “meaning as an instrument,” “meaning of infection control,” and “meaning of caring.”CONCLUSION: Nurses imbue essential meanings of caring on their hands even though they face negative skin symptoms. Furthermore, nurses understand the importance of hand hygiene on infection control. The findings of this study provide an in-depth look into nurses' perceptions of their hands.
Empathy ; Hand Disinfection ; Hand Hygiene ; Hand ; Infection Control ; Skin ; Tertiary Care Centers

PURPOSE: The purpose of this study is to identify factors related to compliance with respiratory infection preventive behaviors including hand washing, cough etiquette, and oral hygiene of older adults. METHODS: A cross-sectional study was conducted with a convenience sample of 100 older adults (mean age: 76.11±6.35 years, female: 86.0%). Data were collected from a community senior center through face to face interviews by using instruments including measuring knowledge, perceived threat, self-efficacy, compliance with respiratory infection preventive behaviors. RESULTS: The mean score of knowledge was 7.52 out of 13 in total. The compliance with hand washing with soap was 6.0% for 8 or more times per day. Among the participants, 12.0% adhered to the cough etiquette. Sixty-two older adults (62.0%) didn't use interdental brushes or floss at all. The stepwise linear regression indicated that age and self-efficacy for respiratory infection preventive behaviors were significant factors and explained 24.0% of the compliance with hand washing and the cough etiquette. Education level, cancer diagnosis, and self-efficacy for respiratory infection preventive behaviors were significant predictors of oral hygiene. The factor with the greatest effect was self-efficacy in the two models. CONCLUSION: The findings suggest that it is necessary to improve compliance with respiratory infection preventive behaviors among older adults using senior centers. In order to enhance the compliance, it is necessary to develop nursing programs based on the self-efficacy for respiratory infection preventive behaviors in the senior centers.
Adult ; Compliance ; Cough ; Cross-Sectional Studies ; Diagnosis ; Education ; Female ; Hand Disinfection ; Hand Hygiene ; Humans ; Linear Models ; Nursing ; Oral Hygiene ; Respiratory Tract Infections ; Senior Centers ; Soaps