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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 1  |  Page : 17-21

Change in perception regarding the use of Biometric devices at a tertiary care hospital in view of COVID-19


1 DepartmentofMicrobiology,AtalBihariVajpayeeInstituteofMedicalSciences,Dr.RamManoharLohiaHospital,NewDelhi, India
2 Department ofCommunityMedicine,R.G.KarMedicalCollegeandHospital,Kolkata,WestBengal, India
3 DepartmentofMicrobiology,AtalBihariVajpayeeInstituteofMedicalSciences,Dr.RamManoharLohiaHospital,NewDelhi; DepartmentofMicrobiology,UCMSandGTBH,Delhi, India

Date of Submission04-Feb-2021
Date of Decision11-Aug-2021
Date of Acceptance15-Aug-2021
Date of Web Publication24-Sep-2021

Correspondence Address:
Dr. Arvind Achra
DepartmentofMicrobiology,AtalBihariVajpayeeInstituteofMedicalSciences,Dr.RamManoharLohiaHospital, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpsic.jpsic_3_21

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  Abstract 


Background: Fingerprint biometric systems are used to identify personnel, grant authorised access and maintain attendance of staff at most places. Despite their many benefits, biometric devices are potential sources of transmission due to contamination from multiple touches by various users. Due to the COVID-19 pandemic, there have been massive shift in infection control practices specially hand hygiene. This study was conducted to understand the attitude and practices of healthcare workers (HCWs) they are likely to follow when biometric devices come to use again.
Materials and Methods: The study was conducted using a self-designed questionnaire given to HCWs in different departments of the hospital in the form of a written form by our infection control nurses. The study was conducted for 5 days. The questionnaire was based on various attitudes and practices before and after the COVID-19 outbreak.
Results: Overall 304 participants filled the questionnaire, which comprised 85 (28%) doctors, 117 (38.4%) nurses and 102 (33.6%) other staff. Before the emergence of COVID-19, 114 (37.5%) participants felt touching biometric devices is more dangerous than touching other common items such as doorknobs, elevator buttons, countertops and staircase railings which now increased to 183 (60.2%) after the COVID-19. Earlier 77% of participants felt that hand sanitisers should be installed near biometric devices, but now 95.7% feel the need of hand sanitisers near the biometric devices and want to use them.
Conclusion: This improvement in hand hygiene might be a result of increased awareness through educational programmes and mass media during the COVID-19 pandemic. Hand sanitisers should be installed near biometric devices before restarting their use which will reduce the risk of contamination of biometric devices by pathogenic organisms.

Keywords: Biometric devices, contamination, COVID-19, hand hygiene, infection control


How to cite this article:
Garg S, Achra A, Tiwary NK, Nirmal K, Arora SK, Shulania A, Duggal N. Change in perception regarding the use of Biometric devices at a tertiary care hospital in view of COVID-19. J Patient Saf Infect Control 2021;9:17-21

How to cite this URL:
Garg S, Achra A, Tiwary NK, Nirmal K, Arora SK, Shulania A, Duggal N. Change in perception regarding the use of Biometric devices at a tertiary care hospital in view of COVID-19. J Patient Saf Infect Control [serial online] 2021 [cited 2021 Dec 5];9:17-21. Available from: https://www.jpsiconline.com/text.asp?2021/9/1/17/326622




  Introduction Top


Biometric fingerprint identity verification is a regular process for attendance at many places. This system implies physical contact between the skin and the surface of the fingerprint reading device. There is a potential risk of microorganisms to be carried on the skin of the hands of the user, to be transferred from hands to the inanimate surfaces like biometric devices, to survive on surfaces, and to be transferred onto the hands of the user in doses exceeding the infectious dose. Previous studies have documented transmission risk for various pathogenic organisms such as enteric viruses, respiratory viruses, enteropathogenic and other drug-resistant bacteria.[1],[2],[3]

The use of such devices in hospitals poses the risk of infection to healthcare workers (HCWs), their families and to the patients if compliance to hand hygiene is poor. The epidemic of coronavirus disease COVID-19 has also put breaks on the use of these devices. Hand hygiene plays important role in the prevention of such infections. Adherence to recommended hand hygiene practices by health-care workers HCWs has been reported to be very variable, ranging from 5% to 89% with an overall average of 38.7%.[4]

The global outbreak of COVID-19 has been a massive driver of infection control, both in the community and health-care settings. With the emergence of COVID-19, knowledge and attitude regarding hygiene as well as regarding the use of biometric devices is expected to change. This study was conducted to do a risk assessment by understanding the attitudes and behavior of hospital staff they are likely to follow when biometric devices come back in use.


  Materials and Methods Top


The study was conducted by giving written questionnaire to all the participants. Each questionnaire was bilingual (English and Hindi) and comprised 13 expected responses. As there was no pre-published standard questionnaire, it was first introduced to a representative 20 participants to know, whether questions are well understood and to develop a range of expected answers. The final questionnaire was then distributed by authors and infection control nurses over a period of 5 days in various departments of the hospital to collect responses from a representative staff. Participants were requested to fill the questionnaire and return hand to hand. Any queries or problems in answering if raised by any individual were dealt at that moment and participants were assisted in filling the questionnaire if required. The study was approved by the Institutional Ethical Committee (419 [68/2020]IEC/172).

Statistical analysis

The data entry was done in the Microsoft Excel spreadsheet and the final analysis was performed with the use of the SPSS Statistics for Windows, version 17.0 (SPSS Inc., Chicago, Ill., USA). The presentation of the categorical variables was done in the form of numbers and percentages.


  Results Top


Overall 304 participants filled the questionnaire, which comprised 85 (28%) doctors, 117 (38.4%) nurses and 102 (33.6%) other staff (technical staff, office staff and multitasking staff etc.). Out of the expected 3952 responses, 3876 responses were answered by participants, giving a response rate of 98%. Of the 304 participants, 232 (76.3%) are involved in clinical work/direct patient care and 193 (63.5%) had undergone formal training regarding COVID-19 infection control in the hospital.

Before the emergence of COVID-19, 114 (37.5%) participants felt touching biometric devices is more dangerous than touching other common items such as doorknobs, elevator buttons, countertops and staircase railings. However, now 183 (60.2%) participants feel it is more dangerous to touch biometric devices. However, 88 (28.9%) felt they are equally dangerous before COVID-19 and now 103 (33.9%) feel they are equally dangerous as compared to touching other common items [Table 1].
Table 1: Cross tabulation for the question 'Do you feel touching biometric devices is more dangerous than touching other common items in the hospital; before COVID versus after COVID'

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Before COVID-19, 234 (77%) participants felt that hand sanitisers should be installed near biometric devices, but now 291 (95.7%) feel the need of hand sanitiser close to the devices [Table 2].
Table 2: Cross tabulation for the question 'Do you think that hand sanitisers should be installed near biometric devices; before COVID versus after COVID'

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222 (73%) participants accepted that they would have used hand sanitisers even before COVID-19 if they were installed near biometric devices, but now 292 (96%) will use hand sanitisers [Table 3].
Table 3: Cross tabulation for the question 'Will you use hand sanitisers if they are installed near biometric devices; before COVID versus after COVID'

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264 (86.8%) participants said that they will use hand sanitisers both before and after using biometric devices, while 9 (3%) will only use before and 25 (8.2%) only after using biometric devices [Table 4].
Table 4: Frequency distribution for the question 'When will you use hand sanitisers'?

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Before COVID-19 only 189 (62.1%) participants always used to perform hand hygiene before leaving the hospital but now 267 (87.8%) participants always perform hand hygiene before leaving the hospital [Table 5].
Table 5: Cross tabulation for the question 'Do you perform hand hygiene before leaving hospital; before COVID versus after COVID'

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227 (74.7%) participants always performed hand hygiene after reaching home even before COVID-19 but the figures jumped up to 285 (93.8%) after the emergence of COVID-19 [Table 6].
Table 6: Cross tabulation for the question 'Do you perform hand hygiene after reaching home; before COVID versus after COVID cross tabulation'

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  Discussion Top


Inanimate environmental surfaces of the hospital such as door handles, elevator buttons, countertops and staircase railings can become contaminated with microorganisms after frequent exposure to HCWs, patients, and visitors.[5],[6],[7],[8]

Similar to other surfaces, biometric devices have also been found to be colonised with pathogenic microorganisms.[2],[3],[9] As hand hygiene practices vary among HCWs, contamination of the biometric devices suggests poor compliance hand hygiene as these devices are exclusively used by HCWs and are not touched by patients or other visitors. Lesser the compliance to hand hygiene, more is likely contamination and increased risk of getting the infection. The contamination of biometric devices also suggests that there is still scope for improvement in hand hygiene practices and it can be achieved by conducting trainings of HCWs on hand hygiene practices.

Although there is an equal risk of getting the infection from all these surfaces (meaning touching them is equally dangerous), higher proportion of HCWs in this study felt that touching biometric devices is more dangerous (38% before COVID-19 vs. 60% after COVID-19) as compared to those feeling they are equally dangerous (29% before COVID-19 vs. 34% after COVID-19). This could be perceived because it is mandatory to touch biometric devices for attendance verification but touching other surfaces can often be avoided.

Although before COVID-19, 202 (66.4%) study participants perceived touching biometric devices as dangerous (either equally or more as compared to other surfaces) a slightly higher numbers 234 (77%) felt the need to install hand sanitisers near biometric devices and 222 (73.0%) accepted that they will use hand sanitisers, suggesting that some participants might not have perceived the danger but feel the need of hand sanitisation. However, after COVID-19, 286 (94%) participants perceived touching biometric devices as dangerous (either equally or more as compared to other surfaces) and this could be perceived because of the discontinuation of biometric attendance verification during the COVID-19 pandemic.

An individual is likely to contaminate the biometric devices if he/she does not sanitise hands before touching the devices and is likely to contaminate own hands from contaminated devices if he/she does not sanitise hands after touching the device. Majority of the study participants 264 (86.8%) wanted to use hand sanitisers both before and after touching the biometric device, thus making it safer for themselves and also for others. However, 25 (8.2%) who will use sanitisers only after using biometric devices are likely to contaminate biometric devices and 9 (3%) only using sanitisers before touching biometric devices are at risk of contaminating their own hands from devices. These individuals can be educated by putting up hand sanitisation display charts near biometric devices.

Although adherence to recommended hand hygiene practices by HCWs while delivering health care has been reported to be very variable, ranging from 5% to 89% with an overall average of 38.7%.[4] Before COVID-19, 244 (80.2%) participants used to perform hand hygiene (always + most of the times) before leaving the hospital, while 268 (88.1%) after reaching home. However, after COVID-19, 295 (97%) participants perform hand hygiene (always + most of the times) before leaving the hospital, while 300 (98.7%) after reaching home. This improvement in hand hygiene might be a result of increased awareness through educational programmes and mass media.


  Conclusion Top


Although questionnaire studies are not a good tool to assess hand hygiene compliance and can be better assessed by direct observation and the actual numbers really performing hand hygiene could be less. However, findings of this study suggest that majority of HCWs have been performing hand hygiene before leaving the hospital and after reaching home earlier also, and these numbers have significantly increased after the emergence of COVID-19. Hand sanitisers should be installed near biometric devices before restarting their use and it is likely that the risk of contamination of biometric devices by pathogenic organisms will be less as compared to pre-COVID-19 times.

Acknowledgements

The authors are very thankful to the following nursing officers of Dr. Ram Manohar Lohia Hospital for their help in questionnaire distribution. Amarjit Kaur (Senior Nursing Officer) Ruth Rani (Senior Nursing Officer) Hemlata Khanna (Senior Nursing Officer) Kavita Khasa (Nursing Officer) Nisha Sharm a (Nursing Officer).

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Jacobs JA, Van Ranst M. Biometric fingerprinting for visa application: Device and procedure are risk factors for infection transmission. J Travel Med 2008;15:335-43.  Back to cited text no. 1
    
2.
Jogender, Sharma P, Gupta P. Bacterial contamination of biometric fingerprinting device – A potential source of hospital acquired infections? Indian J Appl Res 2019;9:1-3.  Back to cited text no. 2
    
3.
Suhag N, Jain A, Kaore NM. Evaluation of transient microbial flora on biometric system as a potential source of infection in tertiary care hospitals. Indian J Microbiol Res 2016;3:1-4.  Back to cited text no. 3
    
4.
WHO Guidelines on Hand Hygiene in Health Care: A Summary. Available from: https://www.who.int/gpsc/5may/tools/who_guidelines-handhygiene_summary.pdf. [Last accessed on 2021 Feb 04].  Back to cited text no. 4
    
5.
Bhatta DR, Hamal D, Shrestha R, Hosuru Subramanya S, Baral N, Singh RK, et al. Bacterial contamination of frequently touched objects in a tertiary care hospital of Pokhara, Nepal: How safe are our hands? Antimicrob Resist Infect Control 2018;7:97.  Back to cited text no. 5
    
6.
Khatib SI. A preliminary study of bacterial contamination from elevators. International Journal of Scientific Research 2013;2:10.  Back to cited text no. 6
    
7.
Kandel CE, Simor AE, Redelmeier DA. Elevator buttons as unrecognized sources of bacterial colonization in hospitals. Open Med 2014;8:e81-6.  Back to cited text no. 7
    
8.
Augustine BO, Frederick OE, Paul IO, Sunday O. The role of door handles in the spread of microorganisms of public health consequences in University of Benin Teaching Hospital (UBTH), Benin City, Edo State. Pharm Sci Technol 2017;2:15-21.  Back to cited text no. 8
    
9.
Nirupa S, Gayathri V, Priyadarshani S. A study on bacterial Flora on the finger printing surface of the biometric devices at a tertiary care hospital. Int J Curr Microbiol Appl Sci 2016;5:441-6.  Back to cited text no. 9
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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