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The Influence of Improved Access to Alcohol-Based Hand Rub and Hand Hygiene Training in Healthcare Facilities on Hand Hygiene Adherence in Belize During COVID-19: June 2021–August 2022

Author

Listed:
  • Kelsey McDavid

    (Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA
    These authors contributed equally to this work.)

  • Anh N. Ly

    (Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children’s Hospital, 1102 Bates Ave, Houston, TX 77030, USA
    These authors contributed equally to this work.)

  • Nicholas Bivens

    (Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children’s Hospital, 1102 Bates Ave, Houston, TX 77030, USA)

  • Francis Morey

    (Belize Ministry of Health and Wellness, East Block Building, National Assembly, Bliss Parade, Belmopan, Belize)

  • Gerhaldine Morazan

    (Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children’s Hospital, 1102 Bates Ave, Houston, TX 77030, USA)

  • Russell Manzanero

    (Belize Ministry of Health and Wellness, East Block Building, National Assembly, Bliss Parade, Belmopan, Belize)

  • Melissa Musa-Diaz

    (Belize Ministry of Health and Wellness, East Block Building, National Assembly, Bliss Parade, Belmopan, Belize)

  • Alexandra Medley

    (Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA)

  • Kristy O. Murray

    (Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children’s Hospital, 1102 Bates Ave, Houston, TX 77030, USA
    Department of Pediatrics, Emory University and Children’s Healthcare of Atlanta, 2015 Uppergate Dr., Atlanta, GA 30329, USA
    These authors also contributed equally to this work.)

  • Matthew J. Lozier

    (Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA
    United States Public Health Service, 1101 Wootton Parkway, Suite 300, Rockville, MD 20852, USA
    These authors also contributed equally to this work.)

Abstract

Access to hand hygiene (HH) resources in clinical settings is important to prevent healthcare-associated infections, including COVID-19. However, many countries, including Belize, have limited national data on the availability of HH resources and healthcare worker (HCW) hand hygiene adherence (HHA) in healthcare facilities (HCFs). We conducted a study in the 11 largest public HCFs across Belize to evaluate access to HH resources and HHA before and after an intervention (provision of alcohol-based hand rub (ABHR) wall mounts and HH training). Descriptive statistics and multilevel logistic regressions were used to assess changes in HH resources and HHA from baseline to follow-up and explore factors associated with HHA. There was a 19 percent increase in rooms with functional wall-mounted ABHR dispensers (44% to 63%) post-intervention. HHA did not improve from baseline (52%) to follow-up (50%). Combining baseline and follow-up data, HHA was higher when ABHR and soap and water were present (aOR = 4.19, 95% CI = 2.11, 8.32) and when only ABHR was present (aOR = 3.85, 95% CI = 1.92, 7.72) compared with when soap and water were present alone. The decreased perceived risk of COVID-19 at follow-up may explain the null HHA findings. However, our assessment of HH resources and practices provides a useful foundation for future HH programs in HCFs.

Suggested Citation

  • Kelsey McDavid & Anh N. Ly & Nicholas Bivens & Francis Morey & Gerhaldine Morazan & Russell Manzanero & Melissa Musa-Diaz & Alexandra Medley & Kristy O. Murray & Matthew J. Lozier, 2025. "The Influence of Improved Access to Alcohol-Based Hand Rub and Hand Hygiene Training in Healthcare Facilities on Hand Hygiene Adherence in Belize During COVID-19: June 2021–August 2022," IJERPH, MDPI, vol. 22(4), pages 1-15, March.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:4:p:514-:d:1622591
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