Focus on specific initiatives to improve hand hygiene in healthcare settings.

 Multiple studies published in 2022 focused on hand hygiene compliance in healthcare settings (Al-Anaziet al., 2022; Kamara et al., 2022). A cross-sectional study by Umar et al. (2022) reported hand hygiene compliance as 34.7% among nurses working in public hospitals in Ethiopia, with positive association between hand hygiene compliance and gender (male), work experience (greater than 5 years), training in hand hygiene, availability of running water, and knowledge of hand hygiene. Another study by Yehouenou et al. (2022) investigated hand hygiene behavior in a public hospital in Benin; several factors, including knowledge, attitudes, and social factors, influenced hand hygiene behavior in this setting. In a qualitative study among healthcare workers in Iran, Ahmadipour et al. (2022) identified three broad categories of barriers to hand hygiene practice in healthcare settings that operate at multiple levels. First, the authors identified barriers related to the individual, which Photo Credit: WaterAid includes two subcategories related to knowledge and attitudes towards hand hygiene. Second, the authors identified barriers related to facility management, which included improper behavioral patterns of supervisors and unsuitable training and planning. Finally, the authors identified barriers related to the organization, which included heavy workloads, improperly designed wards, a lack of equipment (handwashing facilities), and lack of quality equipment (poor quality of soap or disinfectant). Other studies focused on specific interventions or initiatives to improve hand hygiene in healthcare settings. Nalule et al. (2022) conducted a controlled before-and-after study of a multi-modal intervention to improve hand hygiene during the perinatal period in Cambodia. The intervention included hand hygiene infrastructure provision, cues and reminders, and participatory trainings delivered at the facility to improve hand hygiene practices among midwives and caregivers during childbirth through the return to the home environment. The authors found that the intervention led to a significant improvement in hand hygiene compliance among healthcare workers and caregivers in the healthcare facility but limited improvements for caregivers in postnatal care periods (return to the home environment), suggesting the need to improve hand hygiene practices along the continuum of care. Dramowski et al. (2022) implemented the SafeHANDS intervention, also a multimodal hand hygiene intervention, in a resource-limited neonatal unit in Ethiopia. Their intervention included education, reminders, and feedback, leading to a significant improvement in hand hygiene compliance, as well as a reduction in healthcare-associated infections. These studies highlight the importance of implementing multi-modal interventions to improve hand hygiene in healthcare settings, especially in resource-limited settings.