In 2021, an operational research study in two tertiary hospitals, Freetown, showed poor hand hygiene compliance. Recommended actions were taken to improve the situation. Between February-April 2023, a cross-sectional study was conducted in the same two hospitals using the WHO Hand Hygiene tool to assess hand hygiene practices and compare hand hygiene compliance with that observed between June-August 2021. In Connaught hospital, overall hand hygiene compliance improved from 51% to 60% (P<0.001), and this applied to both handwash actions with soap and water and alcohol-based-hand-rub: significant improvements were found in all hospital departments and amongst all healthcare worker cadres. In 34 Military Hospital (34MH), overall hand hygiene compliance decreased from 40% to 32% (P<0.001), with significant decreases observed in all departments and amongst nurses and nursing students. The improvements in Connaught Hospital were attributed to more hand hygiene reminders, better handwash infrastructure and more frequent supervision assessments compared with 34MH where interventions were less well applied, possibly due to extensive hospital reconstruction at the time. In conclusion, improved distribution of hand hygiene reminders, better handwash infrastructure and frequent supervision assessments are effective, and need to be strengthened, scaled-up and combined with other innovative ways to promote good hand hygiene practices.

Predatory research field in science is when an emerging scientific topic destroys current topics and characterizes a main scientific change. Predatory research field can be a basic driver of scientific and technological change that generates a 'creative destruction' in science and society in contexts of knowledge-based competition and rapid changes. The prediction of proposed theory of predatory research fields is that it destroys with a fast growth other research fields. The theoretical approach is tested here in research fields of large language models (LLM) by analyzing the transformers (a deep learning architecture based on the multi-head attention mechanism) proposed in 2017 and from November 2022 started main applications in generative artificial intelligence with innovations of BERT, ChatGPT, Microsoft Copilot (launched on February 7, 2023) and other natural language processing tools driven by AI technology for engaging conversations, gain insights, automate tasks, etc., etc. Statistical evidence suggests that growth rate of transformer technologies is 80.58%, a high level compared to all other research fields in machine learning (having a growth rate of 13.83%). Moreover, predatory research field of transformers has a destructive power such that all other domains in LLM from 2021 to 2023 have a general reduction of scientific growth. The impact of transformers is much more drastic of previous radical technologies such as CNN having a temporal growth rate of 0.16%, lower than 0.38% by transformers, ceteris paribus. These analysis reveals that transformers have characteristics to generate a radical scientific and technological change in a not-too-distant future. Overall, then, the study suggests that predatory research field on emerging topics and technologies can generate path-breaking innovations and the examination here can clarify the essential elements of the science dynamics for a better theory of scientific and technological change, providing also main implications for knowledge policy to support promising research fields and technologies to guide economic and social change.