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. 2023 Aug 31;8(9):431.
doi: 10.3390/tropicalmed8090431.

Have Hand Hygiene Practices in Two Tertiary Care Hospitals, Freetown, Sierra Leone, Improved in 2023 following Operational Research in 2021?

Matilda Mattu Moiwo  1 , Gladys Nanilla Kamara  1   2 , Dauda Kamara  3 , Ibrahim Franklyn Kamara  4 , Stephen Sevalie  1   2 , Zikan Koroma  3 , Kadijatu Nabie Kamara  3 , Matilda N Kamara  5 , Rugiatu Z Kamara  6 , Satta Sylvia Theresa Kumba Kpagoi  3 , Samuel Alie Konteh  7 , Senesie Margao  3 , Bobson Derrick Fofanah  4 , Fawzi Thomas  5   8 , Joseph Sam Kanu  3   5 , Hannock M Tweya  9 , Hemant Deepak Shewade  10 , Anthony David Harries  11   12
Affiliations

Have Hand Hygiene Practices in Two Tertiary Care Hospitals, Freetown, Sierra Leone, Improved in 2023 following Operational Research in 2021?

Matilda Mattu Moiwo et al. Trop Med Infect Dis. .

Abstract

In 2021, an operational research study in two tertiary hospitals in Freetown showed poor hand hygiene compliance. Recommended actions were taken to improve the situation. Between February-April 2023, a cross-sectional study was conducted in the same two hospitals using the World Health Organization hand hygiene tool to assess and compare hand hygiene compliance with that observed between June-August 2021. In Connaught hospital, overall hand hygiene compliance improved from 51% to 60% (p < 0.001), and this applied to both handwash actions with soap and water and alcohol-based hand rub. Significant improvements were found in all hospital departments and amongst all healthcare worker cadres. In 34 Military Hospital (34MH), overall hand hygiene compliance decreased from 40% to 32% (p < 0.001), with significant decreases observed in all departments and amongst nurses and nursing students. The improvements in Connaught Hospital were probably because of more hand hygiene reminders, better handwash infrastructure and more frequent supervision assessments, compared with 34MH where interventions were less well applied, possibly due to the extensive hospital reconstruction at the time. In conclusion, recommendations from operational research in 2021 contributed towards the improved distribution of hand hygiene reminders, better handwash infrastructure and frequent supervision assessments, which possibly led to improved hand hygiene compliance in one of the two hospitals. These actions need to be strengthened, scaled-up and guided by ongoing operational research to promote good hand hygiene practices elsewhere in the country.

Keywords: SORT IT; World Health Organization hand hygiene observation tool; alcohol-based hand rub; antimicrobial resistance; hand hygiene opportunities; hand wash with soap and water; infection prevention and control (IPC); infections acquired in hospital; operational research.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Comparison of hand hygiene compliance (and in relation to use of ABHR or hand wash) between June–August 2021 and February–April 2023 in two tertiary hospitals, Freetown, Sierra Leone: (a) = 34 Military Hospital (34MH); and (b) = Connaught Hospital. ABHR = alcohol-based hand rub; HH = hand hygiene.
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