The study included 150 anesthesiology registrars registered in the Sudanese Council of Anaesthesia and Intensive Care. The mean age of participants was 31 ± 4 years and a female majority of 67%. More than half of them have 2 to 5 years of experience (Table 1).
Table 1
Demographic characteristics of anesthesiology registrars registered in the Sudanese Council of Anaesthesia and Intensive Care 2022 (n = 150).
|
Frequency/Mean ± SD
|
Age
|
31 ± 4
|
Gender
|
|
Male
|
49 (33%)
|
Female
|
101 (67%)
|
Experience
|
|
less than 2 years
|
21 (14%)
|
2 to 5 years
|
77 (51%)
|
more than 5
|
52 (35%)
|
Knowledge of patients prevention among participants was assessed, the majority have known that hand hygiene prevents the transmission of germs to the patient before touching the patient 95%, Immediately after the risk of body fluid exposure 89%, and Immediately before clean/aseptic procedure 91%, however, only 16% knew that hand hygiene can prevent transmission of germs to the patient after exposure to immediate surroundings of the patient (Table 2).
Table 2
Knowledge of HH among anesthesiology registrars registered in the Sudanese Council of Anaesthesia and Intensive Care 2022 (n = 150).
|
Count (%)
|
Hand hygiene prevents the transmission of germs to the patient (patient prevention)
|
Before touching the patient (Yes)
|
142 (95%)
|
Immediately after the risk of body fluid exposure (Yes)
|
134 (89%)
|
After exposure to the immediate surroundings of the patient (No)
|
24 (16%)
|
Immediately before the clean/aseptic procedure (Yes)
|
136 (91%)
|
Hand hygiene prevents the transmission of germs to the health worker (self-protection)
|
After touching the patient (Yes)
|
142 (95%)
|
Immediately after the risk of body fluid exposure (Yes)
|
144 (96%)
|
Immediately before the clean/aseptic procedure (No)
|
33 (22%)
|
After exposure to the immediate surroundings of the patient (Yes)
|
141 (94%)
|
Regarding alcohol based rubbing and hand washing with soap and water
|
Hand rubbing is more rapid for hand cleansing than hand washing (True)
|
107 (71%)
|
Hand rubbing causes skin dryness more than hand washing (False)
|
40 (24%)
|
Hand rubbing is more effective against germs than hand washing (False)
|
78 (52%)
|
Hand washing and rubbing are recommended to be performed in sequence (False)
|
48 (32%)
|
The minimal time needed for alcohol-based hand rub to kill most germs is 20 seconds (True)
|
108 (72%)
|
The type of hand hygiene method is required in the following situations
|
Before palpation of the abdomen (Rubbing)
|
87 (58%)
|
Before giving an injection (Rubbing)
|
79 (53%)
|
After emptying a bedpan (Washing)
|
112 (75%)
|
After making a patient’s bed (Rubbing)
|
51 (34%)
|
After visible exposure to blood (Washing)
|
112 (75%)
|
Before general anesthesia induction (Washing)
|
88 (59%)
|
Before giving a spinal anesthetic (Rubbing)
|
30 (20%)
|
Before attempting nerve block (Washing)
|
119 (79%)
|
Before cannulation (Washing)
|
65 (43%)
|
Before epidural insertion (Rubbing)
|
30 (20%)
|
Before arterial line insertion (Washing)
|
100 (67%)
|
Before central venous catheterization (Rubbing)
|
31 (21%)
|
Regarding knowledge of self-protection, the majority have known that hand hygiene prevents the transmission of germs to the health worker after touching the patient 95%, Immediately after the risk of body fluid exposure 96%, and after exposure to immediate surroundings of the patient 94%, however, only 22% knew that hand hygiene can’t prevent transmission of germs to the health worker after exposure to immediate surroundings of the patient (Table 2).
Upon assessing knowledge of hand washing and rubbing, participants have known that rubbing is more rapid than washing 71%, and the minimal time needed for alcohol-based hand rub to kill most germs on your hands is 20 seconds 72%. Nevertheless, 24% knew that Hand rubbing does not cause skin dryness more than hand washing, 52% knew that Hand rubbing is not more effective against germs than hand washing, and 32% knew that there is no recommendation that Hand washing and hand rubbing are to be performed in sequence (Table 2).
Regarding the appropriate hand hygiene method, participants identified that rubbing is recommended Before palpation of the abdomen 58%, Before giving an injection 53%, After making a patient’s bed 34%, Before giving a spinal anesthetic 20%, Before epidural insertion 20%, and Before central venous catheterization 21%. And washing After emptying a bedpan 75%, after visible exposure to blood 75%, Before general anesthesia induction 58%, Before attempting nerve block 79%, Before canulation 43%, and Before arterial line insertion 67% (Table 2).
Overall, the majority 88% have a fair knowledge regarding hand hygiene, and 12% have poor knowledge (Fig. 1).
Regarding participants' practice of the WHO 5 Moments hand hygiene, hand hygiene was least done Before touching a patient 77%, otherwise, the majority reported doing hand hygiene Before clean/aseptic procedures 91%, After bodily fluid exposure/risk 99%, After touching a patient 93, and After touching patient surroundings 89% (Table 3). Overall 65% were compliant with all the recommended 5 moments of hand hygiene (Fig. 2).
Table 3
Practice of the WHO 5 Moments hand hygiene among anesthesiology registrars registered in the Sudanese Council of Anaesthesia and Intensive Care 2022 (n = 150).
|
Count
|
%
|
Before touching a patient
|
116
|
77%
|
Before clean/aseptic procedures
|
137
|
91%
|
After bodily fluid exposure/risk
|
149
|
99%
|
After touching a patient
|
139
|
93%
|
After touching the patient surroundings
|
134
|
89%
|
Analysis of Factors affecting participants’ compliance with WHO 5 moments revealed that only experience was associated with the participants’ compliance; compliance was 38% in less than 2 years of experience, 62% in 2 to 5 years of experience, and 81% in more than 5 years of experience (p-value 0.002). Compliance was higher in females vs. males (66% vs. 63%) and fair vs poor (66% vs. 61%) however without statistical significance (Table 4).
Table 4
Factors affecting compliance with WHO 5 moments anesthesiology registrars registered in the Sudanese Council of Anaesthesia and Intensive Care 2022 (n = 150).
Factors
|
Compliance
|
Total
|
p-value
|
Not-compliant
|
Compliant
|
Age
|
31 ± 5
|
31 ± 3
|
31 ± 4
|
0.3
|
Gender
|
|
|
|
0.7
|
Male
|
18 (37%)
|
31 (63%)
|
49
|
Female
|
34 (34%)
|
67 (66%)
|
101
|
Experience
|
|
|
|
0.002*
|
< 2 years
|
13 (62%)
|
8 (38%)
|
21
|
2 to 5 years
|
29 (38%)
|
48 (62%)
|
77
|
More than 5
|
10 (19%)
|
42 (81%)
|
51
|
Knowledge
|
|
|
|
0.6
|
Poor
|
7 (39%)
|
11 (61%)
|
18
|
Fair
|
45 (34%)
|
87 (66%)
|
132
|
Total
|
52
|
98
|
150
|
|