Changes in hand hygiene compliance and technique among non-healthcare professionals in a tertiary-care hospital: Before and during the COVID-19 pandemic.

Background: We assessed changes associated with the SARS-CoV-2 (severe acute respiratory coronavirus 2) pandemic on hand disinfection compliance and technique among inpatients and visitors in a German tertiary-care hospital. Methods: Hand disinfection compliance and technique were directly observed. Approximately 10% of observed individuals were included in a questionnaire-based study on motivations and knowledge (voluntary participation). A pre-pandemic period of 5 months was compared with a pandemic period of 10 months during the early phase of the SARS-CoV-2 pandemic in 2020. Results: A total of 5,517 individuals observed as well as 456 observed and questioned were included in the assessment. Among observed individuals, hand disinfection compliance increased from 8.7% (181/2,087) to 24.0% (823/3,430) (P < 0.0001), and correct technique increased from 4.4% (91/2,087) to 10.0% (343/3,430) (P < 0.0001) during the pandemic period. Among volunteers participating in the questionnaire arm, compliance was high pre-pandemic (47.2%; 58/123) and remained stable during the pandemic period (45.6%; 152/333) (P = 0.8325). In this subpopulation, correct technique declined from 28.5% (35/123) to 17.7% (59/333) (P = 0.0136). Conclusions: Moderate pandemic-period-associated improvements in hand disinfection compliance and technique among non-healthcare professionals in healthcare settings may not increase indefinitely, but may reach a saturation level in individuals who already show comparatively high adherence.