Hand Hygiene, Compliance And Alcohol-Based Products: What Was The Legacy Of The COVID-19 Pandemic?

In the era of multidrug-resistant organisms and following the coronavirus disease 2019 (COVID-19) pandemic, the prevention of healthcare-associated infections (HAIs) has become one of the most critical global health concerns. The World Health Organization (WHO) developed the "My Five Moments for Hand Hygiene," encouraging healthcare professionals to improve adherence to hand hygiene (HH), thereby increasing compliance rates and emphasizing alcohol-based hand rubs as the preferred method. We investigated HH compliance and the use of alcohol-based formulations among healthcare professionals working in adult, pediatric, and neonatal intensive care units (ICUs), comparing the pre and post-pandemic periods. In the post-pandemic period, we analyzed HH compliance across ICUs as well as HH practices in each of the WHOs "Five Moments." A total of 2,789 HH opportunities were recorded (1,048 before the pandemic and 1,741 after). Overall compliance rates increased from 61% (640/1,048) before the pandemic to 66% (1,157/1,741) after, a statistically significant difference (p = 0.004). HH compliance is most critical in the moments before patient contact or aseptic procedures, especially in the Adult and Pediatric ICUs. The Neonatal ICU showed superior performance overall, including significantly higher performance during the two most critical periods. The results reinforce that the COVID-19 pandemic led to an increase in healthcare professionals HH compliance, although disparities persist between professional categories and hospital sectors. Furthermore, there was a drastic change in the pattern of selective hand sanitizer use, increasing the likelihood of alcohol use more than fourfold compared to the previous period (OR 4.30; 95% CI 3.32-5.58; p < 0.001).