Compliance of healthcare workers in a psychiatric inpatient ward to infection control practices during the COVID-19 pandemic: a participant observation study supplemented with a self-reported survey

• Published in: BMC infectious diseases 2024-06, Vol.24 (1), p.592-9, Article 592
• Main Authors: Lau, Leonia Hiu Wan, Lam, Queenie Shing Kwan, Siu, Minnie Mei Yi, Tang, Tiffany Sze Ki, Suen, Lorna Kwai Ping, Lam, Simon Ching
• Format: Article
• Language: English
• Subjects: Adult; Alcohol; Compliance; Control; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; Cross infection; Cross Infection - prevention & control; Cross-Sectional Studies; Disease control; Disease prevention; Disease transmission; Drug abuse; Epidemics; Female; Gloves; Guideline Adherence - statistics & numerical data; Hand Hygiene - statistics & numerical data; Health aspects; Health care; Health facilities; Health Personnel - psychology; Healthcare workers; Hong Kong; Humans; Hygiene; Infection Control - methods; Infectious diseases; Influenza; Linen; Male; Medical personnel; Microorganisms; Middle Aged; Nosocomial infections; Nursing; Observational study; Pandemics; Patients; Personal protective equipment; Personal Protective Equipment - statistics & numerical data; Prevention; Protective equipment; Psychiatric Department, Hospital; Psychiatric ward; Public health; Risk factors; SARS-CoV-2; Self Report; Self-reported survey; Severe acute respiratory syndrome coronavirus 2; Standard precautions; Staphylococcus infections; Surveys; Surveys and Questionnaires; Tuberculosis; Viral diseases
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-09429-3

As an emerging infectious disease with a heterogenous and uncertain transmission pattern, coronavirus disease 2019 (COVID-19) has created a catastrophe in healthcare-associated infections (HAIs) and posed a significant challenge to infection control practices (ICPs) in healthcare settings. While the unique characteristics of psychiatric patients and clinical settings may make the implementation of ICPs difficult, evidence is lacking for compliance with ICPs among healthcare workers (HCWs) in a psychiatric setting during the COVID-19 pandemic. A cross-sectional multi-method study based on participant unobtrusive observation coupled with the completion of a self-administered ICP survey was conducted to assess compliance with ICPs among HCWs in a psychiatric inpatient ward in a regional hospital. An online checklist, called eRub, was used to record the performance of HCWs in hand hygiene (HH) and other essential ICPs. Furthermore, a well-validated questionnaire (i.e., Compliance with Standard Precautions Scale, CSPS) was used to collect the participants' self-reported ICP compliance for later comparison. A total of 2,670 ICP opportunities were observed from January to April 2020. The overall compliance rate was 42.6%. HCWs exhibited satisfactory compliance to the wearing of mask (91.2%) and the handling of clinical waste (87.5%); suboptimal compliance to the handling of sharp objects (67.7%) and linen (72.7%); and poor compliance to HH (3.3%), use of gloves (40.9%), use of personal protective equipment (20%), and disinfection of used surface/area (0.4%). The compliance rates of the nurses and support staff to HH were significantly different (χ  = 123.25, p