Implementation of water-less care, including removal of sinks from patient care areas, is an emerging approach to reduce water-borne infections in high-risk areas such as intensive care units (ICUs). This approach, however, requires significant changes from traditional infection control practices and acceptance by healthcare workers (HCWs) for successful transition.
To explore the knowledge, attitudes, practices (KAPs) and perceived challenges of HCWs who transitioned from working in a unit with standard infection control practices to one with water-less ICU care practices.
The study was conducted using a customised 30-item self-reported survey instrument administered to HCWs working in tertiary neonatal units at a single hospital.
Participation rate was 88.6% (101/114), comprising 66.3% (67/101) nurses, 31.0% (31/101) doctors and 3.0% (3/101) allied health professionals. 90.1% (91/101) had positive attitudes and 53.5% (54/101) had good knowledge regarding water-less ICU care. 83.1% (84/101) followed the appropriate practice of hand hygiene when their hands were visibly soiled. Main challenges with water-less ICU care were perceived compromise of personal (46.5% (47/101)) and patient (22.8% (23/101)) hygiene. 43.6% (44/101) reported an increase in skin-related conditions – 10.9% (11/101) had to visit a doctor for this reason, of which 64.0% (7/11) had pre-existing skin conditions.
Despite overall good attitudes and practices toward water-less ICU care, HCWs may have specific concerns related to hygiene and skin conditions which need to be addressed. For units transiting to water-less ICU care, similar surveys may provide valuable information by identifying gaps in KAP to improve compliance.

Copyright © 2024 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.