The hand hygiene objective graphical assessment index: An index to assess macroscopic hand hygiene efficiency

Infectious diseases are a global health problem, and are a major cause of infant mortality. Most middle- and low-income countries have a heavy burden of communicable diseases. There has been no relevant picture pertaining to individual/public hand hygiene because there is no measure to quantify, categorize or compare macroscopic hand scrub levels. Aim: This study aims to present a new index to assess the macroscopic hand hygiene scrub levels. Methodology: The Hand Hygiene Objective Graphical Assessment Index (HOGAI) records the hand hygiene levels based on the net area “not covered” during a hand scrub procedure and labels it into inadequate, basic, intermediate, adequate, advanced, and establishes it on examination of 171 participants. The data were subjected to quantitative analysis, and nonparametric tests were used. Chi-square test was used to test the difference between the males and females. Results: The total percentage of area not covered during the hand scrub ranged from 3.87% to 15.78%. The mean age of the participants were 20.99 (±2.33) years, where 41.52% had “Basic” level of hand hygiene followed by 35.67% having “Intermediate” level and a total of 19.88% had “Adequate” level of hand hygiene with 2.34% at “Advanced” level whereas 0.59% of the participants had “Inadequate” hand hygiene level. On comparison, a nonsignificant statistical difference (P ≥ 0.05) was noted pertaining to hand hygiene assessment between the two gender groups under study. Conclusion: The use of HOGAI paves a landmark into the neglected problem of lack of proper hand scrub and can be utilized in future to train and monitor better hand scrub practices. It complements with relevant information for epidemiologist and policy makers to improve hand scrub guidelines and macroscopic assessment