{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:09:43Z","timestamp":1784182183930,"version":"3.55.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to examine attitudes and behaviors related to hand hygiene among hospital cleaning staff and to identify promoting and inhibiting factors influencing hand hygiene behavior. In addition, existing worldwide target group-specific interventions for this occupational group were mapped.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A comprehensive literature search was conducted for publications from 2009 to 2025 in MEDLINE (via PubMed\n                      <jats:sup>\u00ae<\/jats:sup>\n                      ), the Cochrane Library, CINAHL (via EBSCO), Embase, and Scopus. Additional research was carried out in WHO IRIS, BASE, and Science.gov, and internationally applicable guidelines were identified using the TRIP Database. Included were studies from worldwide somatic acute care hospitals examining hand hygiene compliance, knowledge, attitudes, practices, influencing factors, or interventions among cleaning staff. Texts limited to other hygiene domains, airborne infections, non-acute-care settings, or study populations consisting of mixed occupational groups and not limited to cleaning staff exclusively were excluded. Literature screening was performed in two stages (title\/abstract and full-text screening), and data extraction was conducted by one reviewer using a standardized extraction table.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 33 sources met the inclusion criteria, comprising five guidelines, 25 full-text studies, and three conference abstracts, which formed the primary basis of this review. The conference abstracts identified during the research for which corresponding full texts were not provided were documented for the sake of completeness, but not included in the main analysis and qualitative synthesis, as relevant information may not be available due to the lack of full texts. The base of evidence was heterogeneous and predominantly descriptive, addressing knowledge, attitudes, practices, as well as promoting and inhibiting factors. Identified interventions related to infection prevention and control and hand hygiene among cleaning staff were based on the provision of target group-oriented training materials, simulation-based training, and multimodal approaches and training programs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings indicate overall limited and predominantly descriptive evidence regarding hand hygiene among hospital cleaning staff. This underscores the need for methodologically diverse research as well as the development of target group\u2013specific interventions and guidelines to strengthen infection prevention, particularly hand hygiene, in acute care hospital settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1800229","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:40:41Z","timestamp":1784180441000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hand hygiene among cleaning staff in acute care hospitals: a scoping review"],"prefix":"10.3389","volume":"14","author":[{"given":"Anna-Maria","family":"Rager","sequence":"first","affiliation":[{"name":"Faculty of Human and Health Sciences (FB 11), University of Bremen","place":["Bremen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviane","family":"Scherenberg","sequence":"additional","affiliation":[{"name":"Public Health and Environmental Health, APOLLON University of Applied Sciences","place":["Bremen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"B1","volume-title":"WHO patient safety curriculum guide for medical schools.","year":"2009"},{"key":"B2","volume-title":"WHO guidelines on hand hygiene in health care","year":"2009"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1016\/S0140-6736(00)02814-2","article-title":"Effectiveness of a hospital-wide programme to improve compliance with hand hygiene","volume":"356","author":"Pittet","year":"2000","journal-title":"Lancet."},{"key":"B4","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1016\/S1473-3099(06)70600-4","article-title":"Evidence-based model for hand transmission during patient care and the role of improved practices","volume":"6","author":"Pittet","year":"2006","journal-title":"Lancet Infect Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e73","DOI":"10.1017\/S0950268823000602","article-title":"Exploring the effect of novel six moments on hand hygiene compliance among hospital cleaning staff members: a quasi-experimental study","volume":"151","author":"He","year":"2023","journal-title":"Epidemiol Infect."},{"key":"B6","first-page":"147","article-title":"Hand hygiene monitoring indication of cleaners in medical institutions based on risk identification and cluster analysis","volume":"21","author":"Chen","year":"2022","journal-title":"Chin J Infect Control."},{"key":"B7","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.jhin.2021.03.007","article-title":"Hand-hygiene-related clinical trials reported between 2014 and 2020: a comprehensive systematic review","volume":"111","author":"Clancy","year":"2021","journal-title":"J Hosp Infect."},{"key":"B8","doi-asserted-by":"crossref","unstructured":"Aromataris\n              E\n            \n            \n              Lockwood\n              C\n            \n            \n              Porritt\n              K\n            \n            \n              Pilla\n              B\n            \n            \n              Jordan\n              Z\n            \n          \n          Adelaide\n          JBI\n          JBI manual for evidence synthesis.\n          \n          2024","DOI":"10.46658\/JBIMES-24-01"},{"key":"B9","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann Intern Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1186\/s12874-022-01710-w","article-title":"Restrictions and their reporting in systematic reviews of effectiveness: an observational study","volume":"22","author":"Helbach","year":"2022","journal-title":"BMC Med Res Methodol."},{"key":"B11","volume-title":"Environmental cleaning and infection prevention and control in health care facilities in low- and middle-income countries: trainer's guide","year":"2022"},{"key":"B12","volume-title":"Environmental cleaning and infection prevention and control in health care facilities in low- and middle-income countries: modules and resources.","year":"2022"},{"key":"B13","volume-title":"WHO training package on environmental cleaning: evaluation methodology guide","year":"2024"},{"key":"B14","volume-title":"Aide-memoire: Environmental cleaning, waste and linen management.","year":"2021"},{"key":"B15","volume-title":"The National Cleaning Standards for Acute Healthcare Facilities 2024","year":"2024"},{"key":"B16","first-page":"46","article-title":"Awareness among sanitary workers regarding their job: a survey at tertiary care hospital","volume":"22","author":"Ahmed","year":"2011","journal-title":"Med Forum."},{"key":"B17","doi-asserted-by":"publisher","first-page":"384","DOI":"10.3390\/medicina61030384","article-title":"Hospital hygiene paradox: MRSA and Enterobacter colonization among cleaning staff in a tertiary hospital in Saudi Arabia","volume":"61","author":"Alqurashi","year":"2025","journal-title":"Medicina."},{"key":"B18","doi-asserted-by":"publisher","first-page":"623","DOI":"10.4103\/mjdrdypu.mjdrdypu_415_20","article-title":"Hand hygiene in housekeeping staffs: an assessment of their perceptions and practices in a tertiary care hospital of Kolkata","volume":"14","author":"Dutta","year":"2021","journal-title":"Med J Dr D Y Patil Vidyapeeth."},{"key":"B19","article-title":"Occupational safety and health of cleaning workers in the hospital","author":"Eigenstetter","year":"2018","journal-title":"XXI World Congress on Safety and Health at Work."},{"key":"B20","doi-asserted-by":"publisher","first-page":"302","DOI":"10.2166\/washdev.2022.206","article-title":"Role of cleaners in establishing and maintaining essential environmental conditions in healthcare facilities in Malawi","volume":"12","author":"Elling","year":"2022","journal-title":"J Water Sanit Hyg Dev."},{"key":"B21","doi-asserted-by":"publisher","first-page":"100376","DOI":"10.1016\/j.infpip.2024.100376","article-title":"Infection prevention and control: knowledge, practices and associated factors among cleaners at a national referral hospital in Uganda","volume":"6","author":"Kigozi","year":"2024","journal-title":"Infect Prev Pract."},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1080\/10803548.2015.1100906","article-title":"An analysis of hospital cleaning staff's attitudes and conduct regarding hand hygiene and cleaning","author":"Pirincci","year":"2016","journal-title":"Int J Occup Saf Ergon."},{"key":"B23","doi-asserted-by":"publisher","first-page":"104","DOI":"10.22391\/fppc.1542354","article-title":"Compliance of cleaning staff to standard precautions in hospital hygiene and affecting factors","volume":"9","author":"Sehbal Ye\u015filba\u015f","year":"2024","journal-title":"Fam Pract Palliat Care."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.3390\/ijerph16061067","article-title":"Cleaning staff's attitudes about hand hygiene in a metropolitan hospital in Australia: a qualitative study","volume":"16","author":"Sendall","year":"2019","journal-title":"Int J Environ Res Public Health."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e2318","DOI":"10.1002\/hsr2.2318","article-title":"Compliance and determinants of infection prevention and control practices among sanitary workers in public hospitals, Eastern Ethiopia: a cross-sectional study","volume":"7","author":"Tolera","year":"2024","journal-title":"Health Sci Rep."},{"key":"B26","doi-asserted-by":"publisher","first-page":"77","DOI":"10.3906\/sag-0709-24","article-title":"Evaluation of the knowledge of hospital cleaning staff about prevention of nosocomial infections","volume":"39","author":"Yamazhan","year":"2009","journal-title":"Turk J Med Sci."},{"key":"B27","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1097\/PTS.0000000000000500","article-title":"The invisible staff: a qualitative analysis of environmental service workers' perceptions of the VA Clostridium difficile prevention bundle using a human factors engineering approach","volume":"17","author":"Yanke","year":"2021","journal-title":"J Patient Saf."},{"key":"B28","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.socscimed.2016.12.015","article-title":"Outsourcing cleaning services increases MRSA incidence: evidence from 126 English acute trusts","volume":"174","author":"Toffolutti","year":"2017","journal-title":"Soc Sci Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1062199","DOI":"10.3389\/fpubh.2022.1062199","article-title":"Development and validation of the regarding infection prevention and control among environmental service workers on knowledge, attitudes, practice and experience questionnaire","volume":"10","author":"Chen","year":"2022","journal-title":"Front Public Health."},{"key":"B30","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1080\/10803548.2025.2452732","article-title":"Development of the hospital hygiene standard precautions scale: cleaning staff version","volume":"31","author":"Demirel","year":"2025","journal-title":"Int J Occup Saf Ergon."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.2147\/RMHP.S419110","article-title":"Infection prevention and control practices and associated factors among healthcare cleaners in Gondar City: a cross-sectional survey in Ethiopia","volume":"16","author":"Tesfaye","year":"2023","journal-title":"Risk Manag Healthc Policy."},{"key":"B32","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1177\/1757177409106778","article-title":"Can education and training for domestic staff increase awareness of infection control practices and improve cleanliness within hospitals?","volume":"10","author":"Aziz","year":"2009","journal-title":"J Infect Prev."},{"key":"B33","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.idh.2023.02.003","article-title":"The effectiveness of simulation-based training on KAU hospital housekeeping staff performance","volume":"28","author":"Battan","year":"2023","journal-title":"Infect Dis Health."},{"key":"B34","first-page":"235","article-title":"Effect of health education intervention on controlling occupational health hazards among housekeeping workers at Zagazig University Hospitals","volume":"41","author":"Attia","year":"2022","journal-title":"Latin Am J Pharm"},{"key":"B35","doi-asserted-by":"publisher","first-page":"153","DOI":"10.5472\/marumj.816910","article-title":"Identification of cleaning staff's habits of personal hygiene and evaluation of the effectiveness of the training carried out","volume":"33","author":"Bulut","year":"2020","journal-title":"Marmara Med J."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1017\/ice.2019.183","article-title":"Sustained improvement in hospital cleaning associated with a novel education and culture change program for environmental services workers","volume":"40","author":"Martin","year":"2019","journal-title":"Infect Control Hosp Epidemiol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1016\/j.ajic.2018.02.003","article-title":"Changes in knowledge and attitudes of hospital environmental services staff: the REACH study","volume":"46","author":"Mitchell","year":"2018","journal-title":"Am J Infect Control."},{"key":"B38","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1186\/s13756-024-01491-5","article-title":"Environmental cleaning barriers and mitigation measures identified through two initiatives in four countries, 2018\u20132023: a commentary","volume":"13","author":"Patrick","year":"2024","journal-title":"Antimicrob Resist Infect Control."},{"key":"B39","doi-asserted-by":"publisher","first-page":"188","DOI":"10.3390\/idr15020020","article-title":"Communicable diseases prevalence among refugees and asylum seekers: systematic review and meta-analysis","volume":"15","author":"Taha","year":"2023","journal-title":"Infect Dis Rep."},{"key":"B40","first-page":"92","article-title":"Environmental hygiene for hospital infection prevention and control in Bangladesh: gaps in cleaning staff knowledge, practices, and training","volume":"12","author":"Harun","year":"2023","journal-title":"Antimicrob Resist Infect Control"},{"key":"B41","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ."},{"key":"B42","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.idh.2018.09.070","article-title":"Introduction of enhanced infection prevention and environmental cleaning workshops for hospital cleaning staff","author":"Smith","year":"2018","journal-title":"Infect Dis Health."},{"key":"B43","doi-asserted-by":"publisher","first-page":"S65","DOI":"10.1016\/S0140-6736(19)32401-8","article-title":"Direct and indirect associations between personal protective equipment use and cleaning quality in a tertiary hospital in China: an observational study","volume":"394","author":"Yang","year":"2019","journal-title":"Lancet"},{"key":"B44","doi-asserted-by":"publisher","first-page":"CD005186","DOI":"10.1002\/14651858.CD005186.pub4","article-title":"Interventions to improve hand hygiene compliance in patient care","volume":"9","author":"Gould","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"B45","doi-asserted-by":"publisher","first-page":"100363","DOI":"10.1016\/j.infpip.2024.100363","article-title":"Hand hygiene compliance and improvement interventions in the Eastern Mediterranean Region: a systematic review and meta-analysis","volume":"6","author":"Bajunaid","year":"2024","journal-title":"Infect Prev Pract."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1800229\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:40:44Z","timestamp":1784180444000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1800229\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,16]]},"references-count":45,"alternative-id":["10.3389\/fpubh.2026.1800229"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1800229","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,16]]},"article-number":"1800229"}}