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. 2025 Aug 14;7(4):100481.
doi: 10.1016/j.infpip.2025.100481. eCollection 2025 Dec.

Impact of the COVID-19 pandemic on alcohol-based hand rub consumption and hand hygiene compliance: a cross-sectional study using digital direct-observation tools in Slovakia

Chebenová Vanesa  1   2 , Bučková Veronika  1 , Škvarková Zuzana  1 , Balintová Natália  3 , Sokolová Jaroslava  1   2
Affiliations

Impact of the COVID-19 pandemic on alcohol-based hand rub consumption and hand hygiene compliance: a cross-sectional study using digital direct-observation tools in Slovakia

Chebenová Vanesa et al. Infect Prev Pract. .

Abstract

Background: Hand hygiene (HH) among healthcare professionals (HCPs) is a key component in ensuring safe and high-quality healthcare. Monitoring the Five moments for HH according to World Health Organization (WHO) guidelines remains the gold standard for compliance assessment. Proper HH is the most effective measure to prevent healthcare-associated infections (HAI).

Aim: This cross-sectional study aimed to quantify HH compliance and alcohol-based hand rub (ABHR) consumption among HCPS at the University Hospital Trnava in Slovakia and to compare results between the pre-pandemic and post-pandemic periods.

Methods: HH compliance was monitored during the pre-pandemic period (2018-2019) and the post-pandemic period (2022-2023). Compliance was assessed among different groups of HCPs - physicians, nurses and other healthcare personnel (e.g., physiotherapists, orderlies and students). Monitoring was conducted using WHO methodology and recorded via the OBSERVE app.

Findings: During the pre-pandemic period, overall HH compliance was 50.2% (95% CI, 48.7.-51.8), with nurses demonstrating the highest compliance rate. In the post-pandemic period, HH compliance remained nearly unchanged at (50.8%; 95% CI, 48.9-52.7). ABHR consumption increased significantly during the COVID-19 pandemic, peaking at 48.4 litres/1 000 patient days (PD), but declined to 31.5 litres/1 000 PD by 2023.

Conclusion: The COVID-19 pandemic positively influenced ABHR consumption and raised awareness of the importance of HH in clinical practice. However, overall HH compliance did not improve post-pandemic. Direct observation supported by a digital application proved to be an effective method for collecting HH compliance data.

Keywords: COVID-19; Compliance; Digital technology; Hand hygiene; Observation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
HH compliance at the hospital FNTT by profession before (4 021 opportunities) and after the COVID-19 pandemic (2 570 opportunities).
See this image and copyright information in PMC

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