Compliance with hand hygiene practices and its appropriateness among healthcare workers during COVID-19 pandemic in public health facilities of Tamil Nadu, India

Background: Compliance with appropriate hand hygiene practises is the most efficient and cost-effective intervention that can be implemented in the healthcare setting. Given its importance, we tried to capture the compliance with hand hygiene practises and their appropriateness among healthcare workers during the COVID-19 pandemic in public health facilities in Tamil Nadu. Methods: This cross-sectional study involved doctors, nurses, and allied healthcare professionals from various departments in 18 public healthcare facilities spanning six districts in Tamil Nadu. A random-intercept model was employed for the multivariable logistic regression analysis to evaluate the factors influencing hand hygiene compliance and its adequacy. The effect size was presented as an adjusted odds ratio (aOR) accompanied by a 95% confidence interval (CI). Results: In total, 2733 hand hygiene observations were made. Only during 19.4% (95%CI: 17.9%- 20.9%) of these observations, hand washing was done. Only during 37.9% (95%CI: 33.9%- 42.1%) of these observations, hand washing was done appropriately by following all the essential steps of hand hygiene. Nurses (aOR = 2.49; 95%CI: 1.90-3.26), healthcare workers in General Surgery (aOR = 2.18; 95%CI: 1.53-3.10) and Obstetrics & Gynaecology departments (aOR = 1.75; 95%CI: 1.26-2.43), working in inpatient departments (aOR = 2.64; 95%CI: 1.38-5.04) had significantly higher compliance to hand hygiene practices. Nurses (aOR = 2.58; 95%CI: 1.33-5.01) and General Medicine department healthcare workers (aOR = 1.98; 95%CI: 1.09-3.61) had significantly higher compliance to appropriate hand hygiene practices. Conclusion: Our study shows that only during one-fifth of the observations did healthcare workers do hand washing, and less than 10% did it appropriately by following all the essential steps of hand hygiene.