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Eng TY, Eng NL, Jenkins CA, Grota PG. "Did you wash your hands?": a prospective study of patient empowerment to prompt hand washing by healthcare providers. J Infect Prev 2021; 22:195-202. [PMID: 34659457 DOI: 10.1177/17571774211012767] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 04/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background Hand hygiene is paramount in preventing the spread of healthcare-associated infections especially during disease epidemics. Compliance rates with hand hygiene policies remain below 50% internationally and may be lower in the outpatient care setting. This study assessed the impact of the patient empowerment model on hand hygiene compliance among healthcare providers. Methods From October 2016 to May 2017, patients from a large ambulatory oncology centre were prospectively enrolled. Patients were instructed to observe healthcare providers for hand hygiene compliance and to remind healthcare providers where it was not observed during at least three consecutive encounters. Healthcare provider reactions to this intervention were rated by patients. Patients' hand hygiene knowledge and beliefs were objectively elicited pre and post-study. Results Thirty patients with a median age of 52 years (range 5-91) completed the study for a total of 190 healthcare provider encounters. When initial hand hygiene was not observed, patients offered a reminder in 71 (37.4%) encounters, did not offer a reminder in 73 (38.4%) encounters and forgot to offer a reminder in 24 (14.2%) encounters. Patients perceived positive or neutral reactions in 76.8% of encounters and negative or surprised reactions in 23.2% of encounters. Healthcare provider compliance improved from 11.6% to 48.9% with intervention. Patient hand hygiene knowledge improved by 16% following the study. Conclusions Patient-empowered hand hygiene may be a useful adjunct for improving hand hygiene compliance among healthcare providers and improving patient hand hygiene knowledge, although it may confer an emotional burden on patients.
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Affiliation(s)
- Tony Y Eng
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, USA
| | - Nina L Eng
- School of Medicine, Emory University, Atlanta, USA
| | - Carol A Jenkins
- Department of Radiation Oncology, UT Health San Antonio MD Anderson Cancer Center, San Antonio, USA
| | - Patti G Grota
- Office of Faculty Excellence, School of Nursing, UT Health San Antonio, San Antonio, USA
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Hand Hygiene Compliance at a Canadian provincial cancer centre - the complementary roles of nurse auditor-driven and patient auditor-driven audit processes and impact upon practice in ambulatory cancer care. Am J Infect Control 2021; 49:571-575. [PMID: 33096127 DOI: 10.1016/j.ajic.2020.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND We examined the patterns of hand hygiene compliance (HHC) among health care providers (HCP) as observed by trained nurse and patient auditors over time in an ambulatory care Canadian provincial cancer agency. METHODS Nurse and volunteer patient auditors completed separate standardized forms documenting hand-cleansing opportunities during clinic visits. HHC rates were compared over time by HCP group and by specialty teams. Observations from 10 calendar quarters were analyzed from April 2015 to September 2019. RESULTS Nurse audit HHC rates ranged from 84% to 96%, encompassing 7,213 opportunities with no significant time-dependent trends by linear regression (R2 = 2.3E-005, P = .9895). The patient audit HHC rates ranged from 57% to 82%, encompassing 23,402 opportunities, were lower overall compared to the nurse audit (73.6% vs 89.2%, respectively, P < .0001), but displayed an increasing trend (R2 = 0.5374, P = .0159) over the same 10 time periods. The relative risk ratio for the differences decreased over time (R2 = .5101, P = .0203). Patients acknowledged the importance of HHC and the audit process, but were reticent to remind HCP to comply. CONCLUSIONS The nurse audit measuring HCP HHC before entering and after exiting patient examination rooms showed persistently high compliance over time whereas the patient-driven audit measuring HHC within the examination room increased over time suggesting a training effect upon practice. These measures appeared complementary.
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Wong J, Gallagher M, Friedt J, Trinder K, McKague M, Stevenson K, Cattell V. Health Science Students as PPE Coaches in the Emergency Department - a Pandemic Pilot Project. Infect Prev Pract 2021; 3:100139. [PMID: 34316578 PMCID: PMC8012167 DOI: 10.1016/j.infpip.2021.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/23/2021] [Indexed: 11/24/2022] Open
Abstract
PPE is an integral part of reducing transmission of COVID-19. We assessed a 5-week pilot project of utilising health science student volunteers as PPE coaches in the adult and paediatric emergency department (ED) during the pandemic. PPE coaches were provided with training, PPE checklist, area for written observations, and feedback surveys. Overall, correct PPE use improved over time. Coaches felt safe, that training was adequate, and part of the team. Factors that contributed to project effectiveness included institutional support, role clarification, and continuous feedback from staff. Our findings support the utilisation of students in IPC projects.
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Affiliation(s)
- J Wong
- University of Saskatchewan, Canada
| | | | - J Friedt
- Saskatchewan Health Authority, Canada
| | | | | | | | - V Cattell
- University of Saskatchewan, Canada.,Saskatchewan Health Authority, Canada
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Kato H, Takeda R, Ideno Y, Suzuki T, Sano K, Nakamura K. Physicians' compliance for hand hygiene in medical outpatient clinics: automated hand-hygiene monitoring with touch sensor and wireless internet. Am J Infect Control 2021; 49:50-54. [PMID: 32512079 DOI: 10.1016/j.ajic.2020.05.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Outpatient clinics are reservoirs for significant pathogens. Hand hygiene with alcohol-based hand rubs are measures currently in use to prevent horizontal transmission of infections. The extent of compliance with hand hygiene regulations is unclear and difficult to monitor. METHODS We built an automated monitoring system with a pressure sensor attached to the alcohol-based hand rubs containers. Wireless fidelity (WIFI)-assisted data collection took place over 9 weeks. Interventions included posters, email reminders and newsletters. Hand hygiene compliance before and after these interventions was evaluated. RESULTS Overall compliance with hand hygiene regulations was 6.48%; half of the physicians participating in our study performed hand hygiene at only 3.08% of patient visits. Twenty-four (17.9%) physicians performed hand hygiene with high compliance (≥10%), while 11.2% performed no hand hygiene at all. Physicians in academic positions and those with ≥20 years of experience performed hand hygiene less frequently than did other physicians. Compliance with hand hygiene regulations improved from 6.08% to 6.73% (P < .001) after intervention. DISCUSSION Compliance with hand hygiene among physicians in our outpatient clinics was very low and needs to improve. CONCLUSIONS Interventions improved the compliance somewhat, although additional interventions including education, training and feedback were suggested.
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Affiliation(s)
- Hideaki Kato
- Infection Prevention and Control Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama Japan.
| | - Rie Takeda
- Infection Prevention and Control Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama Japan; Nursing Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama, Japan
| | | | - Tomoyo Suzuki
- Infection Prevention and Control Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama Japan
| | - Kayoko Sano
- Infection Prevention and Control Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama Japan
| | - Kana Nakamura
- Infection Prevention and Control Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama Japan; Nursing Department, Yokohama City University Hospital, Kanazawa-ku, Yokohama, Japan
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Ni L, Wang Q, Wang F, Ni Z, Zhang S, Zhong Z, Chen Z. An interventional implementation project: hand hygiene improvement. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1149. [PMID: 33240998 PMCID: PMC7576019 DOI: 10.21037/atm-20-5480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Good hand hygiene is the most effective basic measure for preventing hospital-acquired infections. This research project, which originated from a project report on improving hand hygiene at a general hospital in Hangzhou, Zhejiang, China, aimed to investigate the effectiveness of hand hygiene improvement among the hospital staff. Methods Since 2017, a hand hygiene improvement project involving the staff of a 2,500-bed general teaching hospital in Zhejiang, China, has been carried out. This study summarized the implementation and effectiveness of the project, which is based on the five factors of systematic evaluation. The research summary was divided into three phases: phase I (December 2017 to August 2018), phase 2 (September 2018 to April 2019), and phase 3 (May 2019 to December 2019). The data of hand hygiene compliance rates of different groups of professionals in the different research periods were statistically analyzed. Results The results showed that continuous intervention led to a gradual increasing trend (Ptrend<0.001) in the hand hygiene implementation rate with as the intervention time and phases progressed. The hand hygiene compliance rates differed significantly during different phases (76.61%, 79.95%, and 83.34% in phases 1, 2, and 3, respectively, P<0.001). At the same time, the compliance rates of hand hygiene at each phase differed significantly between different professions (P<0.001, the compliance rate of hand hygiene among nurses was the highest and lowest among workers). The compliance rate of hand hygiene for different professions during the three phases were: nurses, 84.73%; doctors, 78.35%; interns, 77.62%; and other hospital workers, 72.79%. Conclusions The hand hygiene compliance rate was effectively improved among the hospital staff after the implementation of the hand hygiene improvement project. In this hospital, the project yielded remarkable results. Hand hygiene must be continuously practiced and improved to develop good habits. Effective and detailed planning as well as key factors, such as hand hygiene facilities, information monitoring, the active participation and response of employees, training and education, and supervision and feedback, could help to guarantee the effectiveness of the project.
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Affiliation(s)
- Lingmei Ni
- Infection Prevention and Control Department, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Qunmin Wang
- Anorectal Department, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Fang Wang
- Infection Prevention and Control Department, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zuowei Ni
- Infection Prevention and Control Department, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Sheng Zhang
- Infection Prevention and Control Department, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zifeng Zhong
- Infection Prevention and Control Department, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zuobing Chen
- Department of Rehabilitation Medicine, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Zhou Q, Lai X, Zhang X, Tan L. Compliance measurement and observed influencing factors of hand hygiene based on COVID-19 guidelines in China. Am J Infect Control 2020; 48:1074-1079. [PMID: 32522610 PMCID: PMC7833598 DOI: 10.1016/j.ajic.2020.05.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Higher requirement is put forward in the measurement of hand hygiene (HH) during a pandemic. This study aimed to describe HH compliance measurement and explore observed influencing factors with respect to coronavirus disease 2019 (COVID-19) guidelines in China. METHODS Compliance was measured as the percentage of compliant opportunities based on criteria for 17 moments. The criteria for compliance included HH behavior, procedure, duration, hand drying method, and the overall that counts them all. The observed influencing factors included different departments and areas and protection motivation. Descriptive analysis and logistic regression were performed. RESULTS The compliance of overall criteria, HH behavior, procedure, duration, and hand drying method were 79.44%, 96.71%, 95.74%, 88.93%, and 88.42%, respectively, which were significantly different from each other (P < .001). Meanwhile, the overall and hand drying method compliance in semi-contaminated areas (odds ratio [OR] = 1.829, P < .001; OR = 2.149, P = .001) and hygienic areas (OR = 1.689, P = .004; OR = 1.959, P = .015) were significantly higher than those in contaminated area. The compliance with HH behavior for the motivation of patient-protection (OR = 0.362, P < .001) was lower than that for the motivation of self-protection. CONCLUSIONS HH compliance was firstly measured using different criteria for 17 moments according to COVID-19 guidelines in China. The measurement of HH compliance needs clearer definition and comprehensive practice. Contaminated areas and motivation of patient-protection contribute to lower compliance, which may be addressed by allocating more human resources and increasing supervision and education.
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Affiliation(s)
- Qian Zhou
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoquan Lai
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Li Tan
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Roseira CE, Fittipaldi TRM, Figueiredo RMD. Práticas de medicações injetáveis: conduta referida de profissionais de enfermagem. Rev Esc Enferm USP 2020; 54:e03653. [DOI: 10.1590/s1980-220x2019028003653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 03/01/2020] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: Identificar a conduta referida de profissionais da enfermagem, do estado de São Paulo, sobre Práticas de Medicações Injetáveis. Método: Estudo tipo survey que identificou a frequência referida sobre Práticas de Medicações Injetáveis mediante resposta de questionário eletrônico, validado, entre setembro e dezembro de 2017. Resultados: Considerando as 1.295 respostas computadas, foram identificadas inconformidades como compartilhamento de frascos multidoses para dois ou mais pacientes (10,8%), reutilização de insumos de uso único, como seringas para salinização de pacientes diferentes (1,2%) e reencape de agulhas após uso (4,9%). Foram referidas maior adesão ao uso de luvas para administração de injeções endovenosas (80,5%) e falta de treinamento para manipulação de dispositivos de segurança (13%). Dados correlacionais apontaram que, quanto maior a idade, melhor era a conduta referida na prática de injetáveis. Conclusão: Embora a maioria das condutas configure-se dentro das Boas Práticas de Medicações Injetáveis, há relatos de práticas de risco, como compartilhamento de insumos de uso único. O treinamento para uso de dispositivos de segurança ainda não é uma realidade para todos os profissionais, visto que muitos o referiram como raro.
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Hart AM. Preventing Outpatient Health Care–associated Infections. J Nurse Pract 2019. [DOI: 10.1016/j.nurpra.2019.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tandon N, Kalra S, Balhara YPS, Baruah MP, Chadha M, Chandalia HB, Prasanna Kumar KM, Madhu SV, Mithal A, Sahay R, Shukla R, Sundaram A, Unnikrishnan AG, Saboo B, Gupta V, Chowdhury S, Kesavadev J, Wangnoo SK. Forum for Injection Technique and Therapy Expert Recommendations, India: The Indian Recommendations for Best Practice in Insulin Injection Technique, 2017. Indian J Endocrinol Metab 2017; 21:600-617. [PMID: 28670547 PMCID: PMC5477451 DOI: 10.4103/ijem.ijem_97_17] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Health-care professionals in India frequently manage injection or infusion therapies in persons with diabetes (PWD). Patients taking insulin should know the importance of proper needle size, correct injection process, complication avoidance, and all other aspects of injection technique from the first visit onward. To assist health-care practitioners in their clinical practice, Forum for Injection Technique and Therapy Expert Recommendations, India, has updated the practical advice and made it more comprehensive evidence-based best practice information. Adherence to these updated recommendations, learning, and translating them into clinical practice should lead to effective therapies, improved outcomes, and lower costs for PWD.
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Affiliation(s)
- Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India
| | - Yatan Pal Singh Balhara
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Manash P. Baruah
- Department of Endocrinology, Excel Center (Unit of Excel Care Hospitals), Guwahati, Assam, India
| | - Manoj Chadha
- Department of Endocrinology, P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Hemraj B. Chandalia
- Department of Endocrinology, Diabetes Endocrinology Nutrition Management and Research Centre, Mumbai, Maharashtra, India
| | - K. M. Prasanna Kumar
- Department of Endocrinology and Metabolism, M S Ramaiah Medical College, CEO-Bangalore Diabetes Hospital, Bengaluru, Karnataka, India
| | - S. V. Madhu
- Department of Medicine, Division of Endocrinology and Metabolism, University College of Medical Sciences, New Delhi, India
| | - Ambrish Mithal
- Department of Endocrinology, Medanta Medicity, Gurugram, Haryana, India
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Osmania General Hospital, Hyderabad, Telangana, India
| | - Rishi Shukla
- Department of Endocrinology, Regency Hospital, Private Ltd. and Centre for Diabetes and Endocrinology, Kanpur, Uttar Pradesh, India
| | - Annamalai Sundaram
- Department of Endocrinology, Ambedkar Institute of Diabetes, Government Kilpauk Medical College, Chennai, Tamil Nadu, India
| | - Ambika G. Unnikrishnan
- Department of Clinical Diabetology and Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Banshi Saboo
- Diabetologist and Endocrine and Metabolic Physician, Diacare-Diabetes Care and Hormone Clinic, Ahmedabad, Gujarat, India
| | | | - Subhankar Chowdhury
- Department of Endocrinology, IPGME & R and SSKM Hospital, Kolkata, West Bengal, India
| | - Jothydev Kesavadev
- Jothydev's Diabetes and Reserarch Center, Thiruvananthapuram, Kerala, India
| | - Subhash K. Wangnoo
- Apollo Centre for Obesity, Diabetes and Endocrinology, Indraprastha Apollo Hospital, New Delhi, India
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Abstract
Most recent infection outbreaks caused by unsafe injection practices in the United States have occurred in ambulatory settings. We utilized direct observation and a survey to assess injection practices at 31 clinics. Improper vial use was observed at 13 clinics (41.9%). Pharmacy support and healthcare worker education may improve injection practices. Infect Control Hosp Epidemiol 2017;38:614-616.
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Bjerke W. Infection Prevention Strategies in Cardiac Rehabilitation [1]—A Behavioral Intervention for Patients [2]. Health (London) 2017. [DOI: 10.4236/health.2017.99092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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