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Disinfection booths in the context of COVID-19 pandemic

Jameleddine Chtioui M, Harzallah N, Odabachian Jebali MC, Grati H, Njeh M, Dhidah L, et al.

Tunis Med, 2021 1 23;98(8-9):651-655.
PMID: 33480021

OBJECTIVES: Industries have made claims on the effectiveness of a disinfection procedure in reducing COVID-19 transmission. This procedure is usually performed by automated dispersion of disinfectant on individuals when they go through a booth. This Health Technology Assessment (HTA) report is a systematic review that synthesizes the evidence on the efficacy and safety of using these booths and provides recommendations to the Ministry of Health to facilitate decision-making regarding the relevance of using this technology.
METHODS: A systematic literature review was performed using Pubmed, Web of Science, INAHTA and GIN databases, from inception to June 4, 2020. Three independent reviewers selected eligible studies then extracted and synthesized the evidence. The synthesis was submitted to a multidisciplinary group of experts to provide recommendations.
RESULTS: Two scientific papers and a Malaysian HTA report were included in data synthesis. In light of the resources consulted, spraying disinfectants on humans in booths is not effective and can be toxic. Disinfectants are intended for use on surfaces, not on living tissue and spraying disinfectants on the outside of the body does not kill the virus inside an infected person's body. Furthermore, this procedure may increase the risk of neglecting other effective measures.
CONCLUSION: It is recommended to prohibit the use of disinfection booths in all structures.

Matched MeSH terms: Disinfection/instrumentation*
In situ generation of plasma-activated aerosols via surface acoustic wave nebulization for portable spray-based surface bacterial inactivation

Wong KS, Lim WTH, Ooi CW, Yeo LY, Tan MK

Lab Chip, 2020 05 19;20(10):1856-1868.
PMID: 32342089 DOI: 10.1039/d0lc00001a

The presence of reactive species in plasma-activated water is known to induce oxidative stresses in bacterial species, which can result in their inactivation. By integrating a microfludic chipscale nebulizer driven by surface acoustic waves (SAWs) with a low-temperature atmospheric plasma source, we demonstrate an efficient technique for in situ production and application of plasma-activated aerosols for surface disinfection. Unlike bulk conventional systems wherein the water is separately batch-treated within a container, we show in this work the first demonstration of continuous plasma-treatment of water as it is transported through a paper strip from a reservoir onto the chipscale SAW device. The significantly larger surface area to volume ratio of the water within the paper strip leads to a significant reduction in the duration of the plasma-treatment, while maintaining the concentration of the reactive species. The subsequent nebulization of the plasma-activated water by the SAW then allows the generation of plasma-activated aerosols, which can be directly sprayed onto the contaminated surface, therefore eliminating the storage of the plasma-activated water and hence circumventing the typical limitation in conventional systems wherein the concentration of the reactive species diminishes over time during storage, resulting in a reduction in the efficacy of bacterial inactivation. In particular, we show up to 96% reduction in Escherichia coli colonies through direct spraying with the plasma-activated aerosols. This novel, low-cost, portable and energy-efficient hybrid system necessitates only minimal maintenance as it only requires the supply of tap water and battery power for operation, and is thus suitable for decontamination in home environments.

Matched MeSH terms: Disinfection*
Fulltext Pathological evaluation for sterilization of routinely used prosthodontic and endodontic instruments

Kumar KV, Kiran Kumar KS, Supreetha S, Raghu KN, Veerabhadrappa AC, Deepthi S

J Int Soc Prev Community Dent, 2015 May-Jun;5(3):232-6.
PMID: 26236684 DOI: 10.4103/2231-0762.159962

In daily practice of dentistry, we use same instruments on many patients. Before use, all instruments must be cleaned, disinfected, and sterilized to prevent any contamination. Pre-cleaning and sterilization of some devices can be difficult because of their small size and complex architecture. Dental burs and endodontic files are such instruments. Dental burs come in a variety of shapes and sizes, all with highly complex and detailed surface features.

Matched MeSH terms: Disinfection
Fulltext The trajectory of COVID-19 pandemic and handwashing adherence: findings from 14 countries

Szczuka Z, Abraham C, Baban A, Brooks S, Cipolletta S, Danso E, et al.

BMC Public Health, 2021 10 05;21(1):1791.
PMID: 34610808 DOI: 10.1186/s12889-021-11822-5

BACKGROUND: The COVID-19 pandemic has affected people's engagement in health behaviors, especially those that protect individuals from SARS-CoV-2 transmission, such as handwashing/sanitizing. This study investigated whether adherence to the World Health Organization's (WHO) handwashing guidelines (the outcome variable) was associated with the trajectory of the COVID-19 pandemic, as measured by the following 6 indicators: (i) the number of new cases of COVID-19 morbidity/mortality (a country-level mean calculated for the 14 days prior to data collection), (ii) total cases of COVID-19 morbidity/mortality accumulated since the onset of the pandemic, and (iii) changes in recent cases of COVID-19 morbidity/mortality (a difference between country-level COVID-19 morbidity/mortality in the previous 14 days compared to cases recorded 14-28 days earlier).
METHODS: The observational study (#NCT04367337) enrolled 6064 adults residing in Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Data on handwashing adherence across 8 situations (indicated in the WHO guidelines) were collected via an online survey (March-July 2020). Individual-level handwashing data were matched with the date- and country-specific values of the 6 indices of the trajectory of COVID-19 pandemic, obtained from the WHO daily reports.
RESULTS: Multilevel regression models indicated a negative association between both accumulation of the total cases of COVID-19 morbidity (B = -.041, SE = .013, p = .013) and mortality (B = -.036, SE = .014 p = .002) and handwashing. Higher levels of total COVID-related morbidity and mortality were related to lower handwashing adherence. However, increases in recent cases of COVID-19 morbidity (B = .014, SE = .007, p = .035) and mortality (B = .022, SE = .009, p = .015) were associated with higher levels of handwashing adherence. Analyses controlled for participants' COVID-19-related situation (their exposure to information about handwashing, being a healthcare professional), sociodemographic characteristics (gender, age, marital status), and country-level variables (strictness of containment and health policies, human development index). The models explained 14-20% of the variance in handwashing adherence.
CONCLUSIONS: To better explain levels of protective behaviors such as handwashing, future research should account for indicators of the trajectory of the COVID-19 pandemic.
TRIAL REGISTRATION: Clinical Trials.Gov, # NCT04367337.

Matched MeSH terms: Hand Disinfection
Bacterial disinfection and cell assessment post ultraviolet-C LED exposure for wound treatment

Sheikh J, Swee TT, Saidin S, Yahya AB, Malik SA, Yin JSS, et al.

Med Biol Eng Comput, 2021 May;59(5):1055-1063.
PMID: 33866479 DOI: 10.1007/s11517-021-02360-8

Ultraviolet-C sourced LED (UVC-LED) has been widely used for disinfection purposes due to its germicidal spectrum. In this study, the efficiencies of UVC-LED for Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus) disinfections were investigated at three exposure distances (1, 1.5, and 2 cm) and two exposure times (30 and 60 s). The respective bacterial inhibition zones were measured, followed by a morphological analysis under SEM. The viabilities of human skin fibroblast cells were further evaluated under the treatment of UVC-LED with the adoption of aforesaid exposure parameters. The inhibition zones were increased with the increment of exposure distances and times. The highest records of 5.40 ± 0.10 cm P. aeruginosa inhibition and 5.43 ± 0.11 cm S. aureus inhibition were observed at the UVC-LED distance of 2 cm and 60-s exposure. Bacterial physical damage with debris formation and reduction in size were visualized following the UVC-LED exposures. The cell viability percentages were in a range of 75.20-99.00% and 82-100.00% for the 30- and 60-s exposures, respectively. Thus, UVC-LED with 275-nm wavelength is capable in providing bacterial disinfection while maintaining accountable cell viability which is suitable to be adopted in wound treatment. Bacterial disinfection and human skin fibroblast cell assessment using UVC-LED.

Matched MeSH terms: Disinfection*
Fulltext Handwashing at University Hospital

Yasmin AH, Yasmin MY

Med J Malaysia, 1993 Jun;48(2):251-2.
PMID: 8350809
Matched MeSH terms: Hand Disinfection*
Fulltext Supplementing hand washing with proper use of alcoholic hand rub in a special neonatal care unit in a large academic public health institute at Jabalpur, Madhya Pradesh, India

Singh M, Agrawal A, Sisodia D, Kasar PK, Kaur A, Datta V, et al.

BMJ Open Qual, 2021 11;10(4).
PMID: 34759034 DOI: 10.1136/bmjoq-2020-001131

OBJECTIVE: The purpose was to increase use of alcoholic hand rub (AHR) in specialised newborn care unit (SNCU) to improve hand hygiene in order to reduce neonatal sepsis and mortality at Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur.
DESIGN: A prospective interventional and observational study.
METHODOLOGY: We formed a quality improvement (QI) team in our SNCU consisting of doctors, nurses, auxiliary staff and parents (a floating member) to improve proper use of AHR. To identify the barriers to the problem, we used fishbone analysis tool. The barriers which were not allowing the health providers to use AHR properly identified were amount of AHR in millilitres to be used per day per baby, how much and when the amount of AHR to be indented from the main store and what is the proper site to place the bottle. We used plan-do-study-act cycles to test and adapt solutions to these problems. Within 5-6 weeks of starting our project, AHR use increased from 44 mL to 92 mL per baby per day and this is sustained around 100 mL per baby per day for over 2 years now.
RESULTS: Significant decrease in neonatal mortality was observed (reduced from median of 41.0 between August 2016 and April 2018 to 24.0 between May 2018 and December 2019). The neonates discharged alive improved from 41.2 to 52.3 as a median percentage value. The percentage of babies who were referred out and went Left Against Medical Advice (LAMA) deceased too.
CONCLUSION: Multiple factors can lead to neonatal deaths, but the important factors are always contextual to facilities. QI methodology provides health workers with the skills to identify the major factors contributing to mortality and develop strategies to deal with them. Improving processes of care can lead to improved hand hygiene and saves lives.

Matched MeSH terms: Hand Disinfection*
Plasma cholinesterase screening

Goh CS

Family Practitioner, 1986;9:40-42.

The plasma cholinesterase baseline levels in Malaysian workers are within the guidelines used. There is a need to carry out close monitoring of workers handling organophosphate s even in a well-run, modern factory where there are no hazards in the plant operation. Abnormal results are mainly because many of our workers are unaware of the health hazards and do not follow orders properly, ie personal hygiene, such as washing of hands before eating, etc. The use of temporary workers should be discouraged because of poor compliance with rules and difficulty in follow up. Product stewardship and education of farmers, sprayers and end users are of paramount importance. Finally there is a great need for educaiton of everyone from factory workers, farmers, sprayers to the general public.

Matched MeSH terms: Hand Disinfection
Fulltext Disinfection and the control of nosocomial infection

Lim VKE

Med J Malaysia, 1995 Dec;50(4):289-90.
PMID: 8668044
Matched MeSH terms: Disinfection*
Endoscopic disinfection: practices and recommendations

Tandon RK

J Gastroenterol Hepatol, 1991 1 1;6(1):37-9.
PMID: 1883975
Matched MeSH terms: Disinfection/standards*
Fulltext A qualitative study on personal hygiene knowledge and practices among food handlers at selected primary schools in Klang valley area, Selangor, Malaysia

Tan, S.L., Cheng, P.L., Soon, H.K., Ghazali, H., Mahyudin, N.A.

International Food Research Journal, 2013;20(1):71-76.
MyJurnal

A study was conducted to determine personal hygiene knowledge among 25 food handlers at 12 selected primary schools in Klang Valley area, Selangor, Malaysia. A qualitative approach using in-depth interviews was employed and respondents were selected by a convenience sampling. The results showed that the respondents had basic knowledge on personal hygiene practices, mainly on hand washing (30.7%) and glove use (18.7%). The food handlers (90%) practiced various good hand washing practices, with only 36% did not practice washing hands after eating or drinking. Most respondents (>70%) practiced glove use, however more than 50% did not wash hands with every glove change, change gloves when change type of products and after preparing raw material. The study showed that the food handlers have basic knowledge one good personal hygiene practices. However, some discrepancies were revealed in the proper hand washing procedure. This study recommended good hand washing procedure to be reiterated among the food handlers. There is also an immediate need for continuous training among food handlers regarding good personal hygiene practices.

Matched MeSH terms: Hand Disinfection
Developing correlation equations for converting among coliforms, E. coli and HPC for rainwater disinfection by sunlight

M.T. Amin, M.Y. Han, Tschung-il Kim, A.A. Alazba, M.N. Amin

Sains Malaysiana, 2013;42:1273-1281.

The application of solar disinfection for treating stored rainwater was investigated by the authors using indicator organisms. The multiple tube fermentation technique and pour plate method were used for the detection of microbial quality indicators like total and fecal coliforms, E. coli and heterotrophic plate count. These techniques have disadvantages mainly that these are laborious and time consuming. The correlation of total coliform with that of exposure time is proposed under different factors of weather, pH and turbidity. Statistical tools like root mean square error and coefficient of determination were used to validate these proposed equations. The correlation equations of fecal coliform, E. coli and heterotrophic plate count with total coliform are suggested by using four regression analysis including Reciprocal Quadratic, Polynomial Regression (2 degree), Gaussian Model and Linear Regression in order to reduce the tedious experimental work in similar types of experiments and treatment systems.

Matched MeSH terms: Disinfection
Fulltext An evaluation of knowledge and awareness of disinfection and sterilization among health care workers

Keah KC, Jegathesan M, Tan SC, Chan SH, Che OM, Cheong YM, et al.

Southeast Asian J. Trop. Med. Public Health, 1995 Mar;26(1):51-6.
PMID: 8525420

Awareness of the disinfection and sterilization policy among hospital staff and their knowledge in basic principles and methods of disinfection and sterilization were studied before and after intervention using a self-administered questionnaire. Survey results showed that awareness (56.2%) before intervention was unsatisfactory. The nurses were more aware of the policy than other groups of medical personnel. Those unaware of the policy perform duties from memory or verbal instructions. A significant increase in awareness to 73.3% was observed after intervention (p < 0.05). Knowledge on methods of decontamination, disinfection and sterilization of equipment varies widely from 28.8% to 90.1%. 23.1% were unaware of the temperature used for sterilization while 72.4% did not know how containers of disinfectant should be refill. Only 14.7% knew the recommended method for washing containers. With education improvement was observed. The average knowledge improved from 44.4% to 57.3%. Our results indicated that continuous in-service education is needed to improve, supplement and update knowledge in this field after basic training. In addition orientation programs for new staff should also be aimed at creating awareness and providing information on guidelines and policies related to their duties.

Matched MeSH terms: Disinfection/methods; Disinfection/standards
Norovirus cross-contamination during food handling and interruption of virus transfer by hand antisepsis: experiments with feline calicivirus as a surrogate

Bidawid S, Malik N, Adegbunrin O, Sattar SA, Farber JM

J Food Prot, 2004 Jan;67(1):103-9.
PMID: 14717359

While there is good epidemiological evidence for foods as vehicles for norovirus transmission, the precise means of spread and its control remain unknown. The feline calicivirus was used as a surrogate for noroviruses to study infectious virus transfer between hands and selected types of foods and environmental surfaces. Assessment of the potential of selected topicals in interrupting such virus transfer was also made. Ten microliters of inoculum of feline calicivirus deposited onto each fingerpad of adult subjects was allowed to air dry and the contaminated area on individual fingerpads was pressed (10 s at a pressure of 0.2 to 0.4 kg/cm2) onto 1-cm-diameter disks of ham, lettuce, or brushed stainless steel. The virus remaining on the donor and that transferred to the recipient surfaces was eluted and plaque assayed. Virus transfer to clean hands from experimentally contaminated disks of ham, lettuce, and stainless steel was also tested. Nearly 46 +/- 20.3, 18 +/- 5.7, and 13 +/- 3.6% of infectious virus was transferred from contaminated fingerpads to ham, lettuce, and metal disks, respectively. In contrast, approximately 6 +/- 1.8, 14 +/- 3.5, and 7 +/- 1.9% virus transfer occurred, respectively, from ham, lettuce, and metal disks to hands. One-way analysis of variance test showed that pretreatment (washing) of the fingerpads either with water or with both topical agent and water significantly (P < 0.05) reduced virus transfer to < or = 0.9%, as compared with < or = 2.3 and < or = 3.4% transfer following treatments with either 75% (vol/vol) ethanol or a commercial hand gel containing 62% ethanol, respectively. Despite wide variations in virus transfer among the targeted items used, intervention agents tested reduced virus transfer significantly (P < 0.05) when compared with that without such treatments (71 +/- 8.9%). These findings should help in a better assessment of the potential for cross-contamination of foods during handling and also assist in developing more effective approaches to foodborne spread of norovirus infections.

Matched MeSH terms: Disinfection/methods; Hand Disinfection
Cross-infection control in Malaysian dental practice

Razak IA, Lind OP

Singapore Dent J, 1995 Jul;20(1):11-5.
PMID: 9582683

A questionnaire survey on cross-infection control was conducted among 1371 professionally trained dentists whose names appeared in the Malaysian Government Gazette of 1990. A 73.1 percent response rate was obtained. About 13 percent of the dentists routinely did not wear gloves during treatment of patients as opposed to 54 percent who routinely did. About 83 percent and 52 percent of dentists wore a mask and eyewear or glasses respectively when carrying out dental procedures. About 93 percent of dentists would use a new sterile needle for each patient and about 40 percent would wipe working surfaces with disinfectant after each patient. The practice of sterilizing handpieces was found to be uncommon as opposed to the sterilization of hand instruments. Variations were observed in some of the infection control measures by gender, seniority in service and employment status. More than one-third of the respondents had experienced puncture wounds during the last month prior to the survey.

Matched MeSH terms: Disinfection/methods; Disinfection/statistics & numerical data
Contamination of foods by food handlers: experiments on hepatitis A virus transfer to food and its interruption

Bidawid S, Farber JM, Sattar SA

Appl Environ Microbiol, 2000 Jul;66(7):2759-63.
PMID: 10877765

Hepatitis A virus (HAV) is an important pathogen which has been responsible for many food-borne outbreaks. HAV-excreting food handlers, especially those with poor hygienic practices, can contaminate the foods which they handle. Consumption of such foods without further processing has been known to result in cases of infectious hepatitis. Since quantitative data on virus transfer during contact of hands with foods is not available, we investigated the transfer of HAV from artificially contaminated fingerpads of adult volunteers to pieces of fresh lettuce. Touching the lettuce with artificially contaminated fingerpads for 10 s at a pressure of 0.2 to 0.4 kg/cm(2) resulted in transfer of 9.2% +/- 0.9% of the infectious virus. The pretreatments tested to interrupt virus transfer from contaminated fingerpads included (i) hard-water rinsing and towel drying, (ii) application of a domestic or commercial topical agent followed by water rinsing and towel drying, and (iii) exposure to a hand gel containing 62% ethanol or 75% liquid ethanol without water rinsing or towel drying. When the fingerpads were treated with the topical agents or alcohol before the lettuce was touched, the amount of infectious virus transferred to lettuce was reduced from 9.2% to between 0.3 and 0.6% (depending on the topical agent used), which was a reduction in virus transfer of up to 30-fold. Surprisingly, no virus transfer to lettuce was detected when the fingerpads were rinsed with water alone before the lettuce was touched. However, additional experiments with water rinsing in which smaller volumes of water were used (1 ml instead of 15 ml) showed that the rate of virus transfer to lettuce was 0.3% +/- 0.1%. The variability in virus transfer rates following water rinsing may indicate that the volume of water at least in part influences virus removal from the fingerpads differently, a possibility which should be investigated further. This study provided novel information concerning the rate of virus transfer to foods and a model for investigating the transfer of viral and other food-borne pathogens from contaminated hands to foods, as well as techniques for interrupting such transfer to improve food safety.

Matched MeSH terms: Disinfection/methods; Hand Disinfection
Fulltext Reimplantation of an Extruded Femoral Segment After Gamma Sterilization in A Type IIIA Supracondylar Femur Fracture: A Case Report

Aizah N, Su Y, Shaifulnizam C, MRos M

Malays Orthop J, 2014 Jul;8(2):66-8.
PMID: 25279099 MyJurnal DOI: 10.5704/MOJ.1407.015

Extruded bone is a rare complication of high energy open fractures, and there is only a handful of literature on reimplantation of the extruded segment. No clear guidelines exist regarding timing of reimplantation, stabilization of extruded bone segments, and also bone disinfection and sterilization techniques. Previous reports describe sterilization using thermal or chemical methods. We present a case of successful reimplantation of an extruded metaphyseal segment of femur after gamma sterilization in a fourteen- year old boy.

Matched MeSH terms: Disinfection
Fulltext Effectiveness of health education material during the flood disaster in subdistrict Sri Medan, Batu Pahat, Johore

Faizah, J., Vanitha, S.

Malaysian Journal of Community Health, 2009;15(3):119-125.
MyJurnal

Introduction : The focus of this paper is to evaluate effectiveness of health education material produced and identify effective educational methods in disseminating health-related information. The study explores the knowledge, attitude and practice level among flood victims in Sub-District Sri Medan, Batu Pahat.
Methodology : Convenient sampling method was adopted as a technique to get 195 respondents aged 18 years and above who had stayed in flood relief centres in the district. A set of questionnaire designed to collect data on demography, effectiveness of health education material, accessibility to education materials, preferable educational methods during flood situation, and flood victims knowledge, attitude and practices.
Result : The study found no association between knowledge level and practice of seven steps hand washing. Result showed poster was regarded as most preferable method in disseminating health related information during flood. No association was found in demographic determinants and knowledge. The length of stay in relief centre has significant association with the level of knowledge obtained.
Conclusion : The use of qualitative and quantitative methods together able to determine accurately the effectiveness of the health education materials used during the disaster as well as the impact in behavioral change.

Matched MeSH terms: Hand Disinfection
Hand washing practice in the neonatal intensive care unit

Rasid, M.A., Quah, B.S., Pennie, R.A.

Malaysian Journal of Paediatrics and Child Health, 1998;10(2):46-51.
MyJurnal

The aim of this paper was to study hand washing practices in the Neonatal Intensive Care Unit (NICU), Hospital Universiti Sains Malaysia. All medical personnel handling babies in the NICU were observed without their knowledge for a total of three times before and after an educational intervention between November 1, 1993 and December 31, 1993. Hand washing techniques with both Hibisol Spray and Chlorhexidine were scored from 1-4. The results of the study are shown as follows: the number of personnel observed were: before educational intervention -paediatric doctors (PD) 14, non-paediatric doctors (ND) 13 and nurses (N) 48; after educational intervention - PD 10 , ND 12 and N 42. PD and N washed hands significantly more often than ND (p < 0.001), before and after intervention. PD but not ND or N improved their rate of hand washing after educational intervention PD (p= 0.02). The Hibisol handwashing technique was poor in all groups (77.1% of all observations). The Chlorhexidine hand washing technique was better than Hibisol (p<0.0001). However only 15% of observed washes with Chlorhexidine were well done and almost one third were done poorly. Both Hibisol and Chlorhexidine techniques did not improve after educational intervention. Hand washing was performed more often in the Level III than Level II nursery [85% of all observations in Level III and 73% of all observations in Level II, p=0.002]. In conclusion, the present educational program is not sufficient and more direct means should be taken to improve the frequency of hand washing among all medical personnel. All medical personnel in the NICU should be educated in the use of the Hibisol, otherwise Hibisol should be removed from the nursery.
Keywords: Handwashing, doctors, neonatal intensive care unit, nurses
Study site: Hospital Universiti Sains Malaysia, Kelantan, Malaysia

Matched MeSH terms: Hand Disinfection
Fulltext Knowledge and practice of medical students of the usage of personal protective equipment: a comparison of two cohorts of students at the International Medical University

Thiruselvi Subramaniam, Rosalind Chi Neo Loo

International e-Journal of Science, Medicine & Education, 2015;9(2):25-31.
MyJurnal

Introduction: Standard precautions in health care is the essence of medical practice encompassing the safety of patients and health care workers including medical students. Barriers to the proper use of personal protective equipment (PPE) exist across the world but identification of areas of weaknesses and appropriate remedies will reduce them. This study assesses knowledge and use of PPE among fourth year students after a period of educational interventions.
Objective: To evaluate appropriate use, awareness and knowledge about PPE among fourth year students after interventions.
Method: A cross- sectional study where forty year 4 students (Group B) were randomly observed and later asked to answer a questionnaire. Students had undergone interventions to improve PPE use, which included lectures and video sessions during each posting. Results were compared with a previous group (Group A). Chi-square test or Fisher’s exact test was used to analyse the data.
Results: There was statistically significant improvement in the use of PPE like wearing and removing mask during invasive procedures (p < 0.001) and hand-washing before and after a non- invasive task (p < 0.001) . Comparison of Groups A and B on the results of the questionnaire for ‘Questions in which more than 10% students answered incorrectly’, showed that there was improvement in Group B in all the questions, some being statistically significant with p value=0.01.
Conclusion: An overall improvement in the use of the PPE and knowledge was noted. Sometimes, students’ attitude and personality may be a challenge and these students may defy changes, but this can be overcome if the strategies are embedded in the curriculum and taught from as early as the first semester.

Matched MeSH terms: Hand Disinfection

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