Peri-Pandemic Hand Hygiene Practices Intensify Despite Decreased Understanding

Optometry students may benefit from a review of hand hygiene protocols during each year of study.

Hand hygiene practices appeared to increase for optometry students during the COVID-19 pandemic, according to research published in Clinical Optometry. However, the students became less knowledgeable of World Health Organization (WHO) guidelines and perceived these practices to involve a great deal of effort compared with pre-pandemic attitudes.

The cross-sectional study included 71 optometry students in 2019 (mean age, 22.29 years, 76% women) and 78 optometry students in 2022 (mean age, 21.76 years, 74% women) in their third and fourth year of study. Participants completed the WHO hand hygiene knowledge and perception questionnaire for health care workers and researchers evaluated changes between the groups through statistical analyses.   

A significant change in the use of alcohol-based hand rub was noted in 2022 compared with 2019 (87.2% vs 46.5%; P <.01). However, an increase in the knowledge of best practices did not accompany this change in practice. Only 41% of students reported an awareness that a minimum of 20 seconds is required for effective hand cleaning with an alcohol-based hand rub in 2022 compared with 44% in 2019.  A total of 28.1% of participants correctly identified germs already present on the patient as the cause of healthcare associated infections in 2019, and this percentage was reduced to 16.7% in 2022.

A higher percentage of students reported perceiving hand hygiene practices to be more problematic in 2022 (81.8%) compared with 2019 (63.8%), according to the report. However, they also reported that it was more important to perform these procedures in front of patients in 2022 compared with 2019 (79.2% vs 40.8%; P <.01).  

The suggestion is that HH modules should be included in each year of study during the course of a medical student’s learning program.

“It has been shown that the retention of [hand hygiene] and infection control knowledge are not being sustained through years of study,” according to the researchers. “Thus, if the requirements for [hand hygiene] and infection control are not repeated on a regular basis, retention of the information is reduced. The suggestion is that [hand hygiene] modules should be included in each year of study during the course of a medical student’s learning program.”

This research was limited by the overrepresentation of women in the study population.


Richter SM, Barnard TG. Knowledge, attitudes, and perceptions towards hand hygiene of optometry students pre- and peri-COVID-19 at a tertiary institution in Johannesburg, South Africa. Clin Optom. Published online October 27, 2022. doi:10.2147/OPTO.S379659