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Aslan L, Subasi O, Mizikoglu D, Birsel O, Kirisci ST, Bas A, Arshad M, Lazoglu I, Seyahi A. A new checklist surgical hand scrub to replace time-based methods - A pixel intensity analysis. Surgeon 2023; 21:344-350. [PMID: 37121827 DOI: 10.1016/j.surge.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/29/2023] [Accepted: 04/13/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Hand scrubbing is an absolute precaution to avoid surgical site infections. World Health Organization (WHO) recommends 4-min overall scrubbing (4MS) for surgical hand hygiene. However, we hypothesize that the more methodical 10-stroke counting technique (10SS) via locational partitioning of the arm is superior to WHO's superficial guideline dictating only the duration. PURPOSE The mechanical efficiency of 4MS and 10SS techniques are compared. METHODS 24 healthcare professionals were recruited for the study. A novel methodology was devised to quantify the average brightness change of skin-applied UV ink before and after scrubbing via pixel intensity analysis. A black-box setup is constructed with an integrated high-resolution camera to photograph the UV-stained dorsal arm. Each stain was then digitally isolated for brightness comparison. RESULTS It was observed that the 10SS technique was overall more successful in removing the UV ink in comparison to the 4MS method (p = 0.014). In addition, a bias was observed in removing more percentage of the proximal stains when compared to middle and distal stains with the 4MS technique (p = 0.0027), while location-based brightness change averages were statistically equal with the 10SS technique (p = 0.423). CONCLUSIONS AND CLINICAL RELEVANCE 10SS provided not only a more mechanically efficient scrubbing but also a more homogenous cleaning than 4MS. We recommend the use of the 10SS technique to achieve more effective pre-surgical hand hygiene.
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Affiliation(s)
- Lercan Aslan
- Koc University Hospital, Department of Orthopaedics and Traumatology, Istanbul 34365, Turkey.
| | - Omer Subasi
- Manufacturing and Automation Research Center, Koc University, Istanbul 34450, Turkey
| | - Duygu Mizikoglu
- Koc University Hospital, Operation Room Nursery, Istanbul 34365, Turkey
| | - Olgar Birsel
- Koc University, School of Medicine, Department of Orthopaedics and Traumatology, Istanbul 34365, Turkey
| | - Seval Tanrikulu Kirisci
- Koc University, School of Medicine, Department of Orthopaedics and Traumatology, Istanbul 34365, Turkey
| | - Ada Bas
- Koc University Hospital, Department of Orthopaedics and Traumatology, Istanbul 34365, Turkey
| | - Munam Arshad
- Manufacturing and Automation Research Center, Koc University, Istanbul 34450, Turkey
| | - Ismail Lazoglu
- Manufacturing and Automation Research Center, Koc University, Istanbul 34450, Turkey
| | - Aksel Seyahi
- Koc University, School of Medicine, Department of Orthopaedics and Traumatology, Istanbul 34365, Turkey
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Tremblay MA, Yin H, Ould-Brahim F, Abou Sader M, Longtin Y. Investigation of individual nurses' relative hand hygiene performance using an anonymous automated electronic hand hygiene monitoring system and a nursing assignment schedule. Am J Infect Control 2023; 51:149-153. [PMID: 35671847 DOI: 10.1016/j.ajic.2022.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND We investigated whether an anonymous automated electronic monitoring system (EMS) could be used to compare hand hygiene (HH) performance of individual nurses. METHODS Prospective observational cohort study. HH performance in 10 acute-care patient rooms was estimated through an EMS that anonymously measured HH events, and room entries and exits. The association between patient room's HH compliance and the nurse in charge of each room was investigated by comparing percentile rank distributions, and through a negative binomial model. RESULTS Over 99 days, there were 38,596 HH events and 135,546 room entries and exits (global HH performance, 28%). For 10 of 54 (19%) nurses, the median HH percentile rank of the rooms to which they were assigned was higher than the group average (P < .001; range of percentiles, 64th to 85th). A lower median percentile was seen in 9/54 (17%) participants (P < .001; range of percentiles, 22nd to 39th). The negative binomial model confirmed this association and identified 15 of 54 high performers (range of adjusted incidence rate ratios [aIRR], 1.17-1.83) and 16 of 54 low performers (range of aIRR, 0.37-0.77). DISCUSSION AND CONCLUSIONS An association exists between a room's HH rate and its assigned nurse. This association could hold potential value for an individualized feedback strategy.
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Affiliation(s)
- Maxime-Antoine Tremblay
- Jewish General Hospital Sir Mortimer B. Davis division of infectious diseases, Montréal, QC, Canada
| | - Hui Yin
- Lady Davis Institute for Medical Research, Center for Clinical Epidemiology, Jewish General Hospital, Montréal, QC, Canada
| | - Fares Ould-Brahim
- McGill University Faculty of Medicine Division of Infectious Diseases, 3605 Rue de la Montagne, Montréal, QC, Canada
| | - Mona Abou Sader
- Jewish General Hospital Sir Mortimer B. Davis division of infectious diseases, Montréal, QC, Canada
| | - Yves Longtin
- Jewish General Hospital Sir Mortimer B. Davis division of infectious diseases, Montréal, QC, Canada; Lady Davis Institute for Medical Research, Center for Clinical Epidemiology, Jewish General Hospital, Montréal, QC, Canada; McGill University Faculty of Medicine Division of Infectious Diseases, 3605 Rue de la Montagne, Montréal, QC, Canada.
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Hoang TKD, Binh QA, Bui XT, Le TH, Dang BT, Nguyen HH, Ngo TTM, Kohler P, Makohliso S, Maryna P, Raab M, Vanobberghen A, Hayter A, Schönenberger K. Assessment of water, sanitation, and hygiene services in district health care facilities in rural area of Mekong Delta, Vietnam. ENVIRONMENTAL MONITORING AND ASSESSMENT 2022; 194:775. [PMID: 36255561 DOI: 10.1007/s10661-022-10179-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/12/2021] [Indexed: 06/16/2023]
Abstract
Access to sufficient water, sanitation, and hygiene (WASH) services is a crucial requirement for patients during therapy and general well-being in the hospital. However, in low- and middle-income countries, these services are often inadequate, resulting in increased morbidity and mortality of patients. This study aimed at assessing the current situation of WASH services in six District Health Care Facilities (DHCFs) in rural areas of the Mekong Delta provinces, Vietnam. The results showed that these services were available with inappropriate quality, which did not compromise the stakeholders' needs. The revealed WASH infrastructures have raised concerns about the prolonged hospital stays for patients and push nosocomial infections to a high level. The safety of the water supply was doubted as the high E. coli (> 60%) and total coliform incidence (86%) was observed with very low residual chlorine concentration (< 0.1 mg/L) in water quality assessment. Moreover, water supply contained a high concentration of iron (up to 15.55 mg/L) in groundwater in one DHCF. Technical assessment tool analysis proved that the improper management and lack of knowledge by human resources were the primary roots of the observed status WASH services. Improvement of the perceptions of WASH should be done for the hospital staff with collaboration and support from the government to prevent incidents in the future.
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Affiliation(s)
- Thi-Khanh-Dieu Hoang
- Key Laboratory of Advanced Waste Treatment Technology & Faculty of Environment and Natural Resources, Ho Chi Minh City University of Technology (HCMUT), 268 Ly Thuong Kiet street, district 10, Ho Chi Minh City, 700000, Vietnam
- Vietnam National University Ho Chi Minh (VNU-HCM), Linh Trung Ward, Ho Chi Minh City, 700000, Vietnam
| | - Quach-An Binh
- Dong Nai Technology University, Dong Nai, Bien Hoa City, Vietnam
| | - Xuan-Thanh Bui
- Key Laboratory of Advanced Waste Treatment Technology & Faculty of Environment and Natural Resources, Ho Chi Minh City University of Technology (HCMUT), 268 Ly Thuong Kiet street, district 10, Ho Chi Minh City, 700000, Vietnam.
- Vietnam National University Ho Chi Minh (VNU-HCM), Linh Trung Ward, Ho Chi Minh City, 700000, Vietnam.
| | - Thi-Hieu Le
- Key Laboratory of Advanced Waste Treatment Technology & Faculty of Environment and Natural Resources, Ho Chi Minh City University of Technology (HCMUT), 268 Ly Thuong Kiet street, district 10, Ho Chi Minh City, 700000, Vietnam
- Vietnam National University Ho Chi Minh (VNU-HCM), Linh Trung Ward, Ho Chi Minh City, 700000, Vietnam
| | - Bao-Trong Dang
- HUTECH University, 475A, Dien Bien Phu, Ward 25, Binh Thanh District, Ho Chi Minh City, Vietnam
| | - Hong-Hai Nguyen
- Institute of Environmental Sciences, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Thi-Tra-My Ngo
- Key Laboratory of Advanced Waste Treatment Technology & Faculty of Environment and Natural Resources, Ho Chi Minh City University of Technology (HCMUT), 268 Ly Thuong Kiet street, district 10, Ho Chi Minh City, 700000, Vietnam
- Vietnam National University Ho Chi Minh (VNU-HCM), Linh Trung Ward, Ho Chi Minh City, 700000, Vietnam
| | - Petra Kohler
- EssentialTech Centre, Ecole Polytechnique Fédérale de Lausanne, Station 10, EPFL 1015, Lausanne, Switzerland
| | - Solomzi Makohliso
- EssentialTech Centre, Ecole Polytechnique Fédérale de Lausanne, Station 10, EPFL 1015, Lausanne, Switzerland
| | - Peter Maryna
- University of Applied Sciences & Arts, Northwestern Switzerland, Muttenz, Switzerland
| | - Martin Raab
- Swiss Tropical and Public Health, Allschwil, Switzerland
| | - Alexandre Vanobberghen
- Health Technology and Telemedicine Unit (HTTU) of the Swiss Centre for International Health (SCIH), Basel, Switzerland
| | | | - Klaus Schönenberger
- EssentialTech Centre, Ecole Polytechnique Fédérale de Lausanne, Station 10, EPFL 1015, Lausanne, Switzerland
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Saveanu CI, Anistoroaei D, Todireasa S, Saveanu AE, Bobu LI, Bamboi I, Boronia O, Balcos C. Evaluation of the Efficiency of Hand Hygiene Technique with Hydroalcoholic Solution by Image Color Summarize. Medicina (B Aires) 2022; 58:medicina58081108. [PMID: 36013575 PMCID: PMC9413243 DOI: 10.3390/medicina58081108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/03/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: The HH (hand hygiene) technique is relatively simple. Even so, in practice there are still non-conformities regarding this aspect. Lack of knowledge or lack of compliance can be reasons for non-adherence with HH techniques. In this context, the purpose of this study was to follow the realization of the hand-washing technique with hydroalcoholic solution, applied before and after receiving the HH recommendations. Materials and Methods: A descriptive, cross-sectional study was conducted from May 2022 to June 2022. Students from a second year dental medicine class teaching in French 2021/22 “Grigore T. Popa” University of Medicine and Pharmacy in Iasi were included in the study. The approval of the ethics commission was received: No. 184/05.05.2022. The study was conducted in two stages. In the first stage, HH was performed without any recommendation. In the second stage, the antiseptic hand rubbing technique was presented following the WHO recommendations. The fluorescent Fluo-Add solution, Wood lamp for dermatology (4 × 5.5 W ultraviolet tubes with a wavelength of 360 nm), and photo camera were used. Subjects performed their HH movement before and after receiving instructions according to WHO. Images were initially taken from the backhand and palm and were finally analyzed with Image Color Summarizer. The data were analyzed by the Mann–Whitney U Test, t-test paired samples using IBM-SPSS version 26 (IBM, Armonk, NY, USA), and p ≤ 0.05 was considered statistically significant. Results: After analyzing the images, there were 70 subjects, 45.7% (32) female and 54.33% (38) male. Final average covered area of backhand was 60.89% (±17.17), 28.84:86.11, compared to 52.07% (±17.04), 9:85.23. Final average covered area for palm was 69.91% (±13.5), 31.61:93.41 compared to 59.74% (±16.64), 26.13:92.72. No statistical significance was obtained by gender. Conclusions: The study showed an improvement in hand hygiene technique without highlighting gender differences.
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Affiliation(s)
| | - Daniela Anistoroaei
- Correspondence: (D.A.); (A.E.S.); Tel.: +40-721-377-269 (D.A.); +40-0755569120 (A.E.S.)
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Ortiz MB, Karapetrovic S. Developing Internet of Things-related ISO 10001 Hand Hygiene Privacy Codes in healthcare. TQM JOURNAL 2022. [DOI: 10.1108/tqm-03-2022-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeAugmentation of an ISO 10001 code system for healthcare worker (HW) satisfaction with ISO/IEC 27701 and ISO/IEC 29184 privacy-related subsystems is shown. Four specific codes regarding the privacy of HWs using electronic devices for hand hygiene (HH) monitoring and the related activities are presented.Design/methodology/approachHWs’ concerns involving automated hand hygiene monitoring technologies were identified through a literature review and classified. Privacy codes (PCs) that deal with such concerns were developed. ISO/IEC 27701 requirements for privacy information were mapped to the elements of these codes, labelled as “Healthcare Workers’ Hand Hygiene Privacy Codes (HW-HH-PCs)”. Both ISO/IEC 27701 and ISO/IEC 29184 guidelines for Privacy Notices and consent were linked with the activities for preparing the code resources.FindingsComponents of an ISO/IEC 27701 system, the guidance of ISO/IEC 29184 and the definitions provided in ISO/IEC 29100 can assist the preparation of HW-HH-PCs and the required resources. An ISO/IEC 29184 Privacy Notice can be used as input for developing an Informed Consent Form, which can be implemented to suit two of the four developed HW-HH-PCs.Practical implicationsHW-HH-PCs and the supporting resources, which healthcare organizations could implement to potentially increase quality assurance of an automated HH monitoring service, are illustrated.Originality/valueIntegrative augmentation of ISO 10001:2018, ISO/IEC 27701:2019 and ISO/IEC 29184:2020 within an underlying framework from ISO/IEC 20000–1:2018 for information technology service, together with the related examples of privacy-related customer satisfaction codes and the corresponding resources, is introduced.
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Generoso JR, Casaroto E, Neto AS, Prado M, Gagliardi GM, de Menezes FG, Gonçalves P, Hohmann FB, Olivato GB, Gonçalves GP, Pereira AM, Xavier N, Miguel MF, da Silva Victor E, Edmond MB, Marra AR. Comparison of two electronic hand hygiene systems using real-time feedback via wireless technology to improve hand hygiene compliance in an intensive care unit. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e127. [PMID: 36483415 PMCID: PMC9726596 DOI: 10.1017/ash.2022.270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 04/25/2023]
Abstract
BACKGROUND Most hand hygiene (HH) intervention studies use a quasi-experimental design, are primarily uncontrolled before-and-after studies, or are controlled before-and-after studies with a nonequivalent control group. Well-funded studies with improved designs and HH interventions are needed. OBJECTIVES To evaluate healthcare worker (HCW) HH compliance with alcohol-based hand rub (ABHR) through direct observation (human observer), 2 electronic technologies, a radio frequency identification (RFID) badge system, and an invasive device sensor. METHODS In our controlled experimental study, 2,269 observations were made over a 6-month period from July 1 to December 30, 2020, in a 4-bed intensive care unit. We compared HH compliance between a basic feedback loop system with RFID badges and an enhanced feedback loop system that utilized sensors on invasive devices. RESULTS Real-time feedback by wireless technology connected to a patient's invasive device (enhanced feedback loop) resulted in a significant increase in HH compliance (69.5% in the enhanced group vs 59.1% in the basic group; P = .0001). CONCLUSION An enhanced feedback loop system connected to invasive devices, providing real-time alerts to HCWs, is effective in improving HH compliance.
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Affiliation(s)
- José R Generoso
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Eduardo Casaroto
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Ary Serpa Neto
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
- Monash University, ANZIC-RC, Melbourne, New South Wales, Australia
| | - Marcelo Prado
- Universidade de São Paulo, São Carlos, São Paulo, Brazil
| | | | | | - Priscila Gonçalves
- Infection Control Unit, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Fábio Barlem Hohmann
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Guilherme Benfatti Olivato
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Gustavo Potratz Gonçalves
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Andréa Marques Pereira
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Nathalia Xavier
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Marcelo Fernandes Miguel
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Elivane da Silva Victor
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Michael B Edmond
- West Virginia University School of Medicine, Morgantown, West Virginia, United States
| | - Alexandre R Marra
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
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Kelly D, Purssell E, Wigglesworth N, Gould DJ. Electronic hand hygiene monitoring systems can be well-tolerated by health workers: Findings of a qualitative study. J Infect Prev 2021; 22:246-251. [PMID: 34880946 PMCID: PMC8647641 DOI: 10.1177/17571774211012781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 04/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Electronic hand hygiene monitoring overcomes limitations associated with manual audit
but acceptability to health workers varies and may depend on culture of the ward and the
nature of the system. Objectives: Evaluate the acceptability of a new fifth type electronic monitoring system to
frontline health workers in a National Health Service trust in the UK. Methods: Qualitative interviews with 11 informants following 12 months experience using an
electronic monitoring system. Results: Informants recognised the importance of hand hygiene and embraced technology to improve
adherence. Barriers to hand hygiene adherence included heavy workload, dealing with
emergencies and ergonomic factors related to placement of alcohol dispensers. Opinions
about the validity of the automated readings were conflicting. Some health workers
thought they were accurate. Others reported problems associated with differences in the
intelligence of the system and their own clinical decisions. Opinions about feedback
were diverse. Some health workers thought the system increased personal accountability
for hand hygiene. Others ignored feedback on suboptimal performance or ignored the data
altogether. It was hard for health workers to understand why the system registered some
instances of poor performance because feedback did not allow omissions in hand hygiene
to be related to the context of care. Conclusion: Electronic monitoring can be very well tolerated despite some limitations. Further
research needs to explore different reactions to feedback and how often clinical
emergencies arise. Electronic and manual audit have complementary strengths.
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Affiliation(s)
- D Kelly
- School of Healthcare Sciences, Cardiff University, UK
| | - E Purssell
- School of Health Sciences, City, University of London, UK
| | - N Wigglesworth
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, UK
| | - D J Gould
- School of Health Sciences, City, University of London, UK
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Abstract
Hand hygiene by health care personnel is an important measure for preventing health care-associated infections, but adherence rates and technique remain suboptimal. Alcohol-based hand rubs are the preferred method of hand hygiene in most clinical scenarios, are more effective and better tolerated than handwashing, and their use has facilitated improved adherence rates. Obtaining accurate estimates of hand hygiene adherence rates using direct observations of personnel is challenging. Combining automated hand hygiene monitoring systems with direct observations is a promising strategy, and is likely to yield the best estimates of adherence. Greater attention to hand hygiene technique is needed.
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Affiliation(s)
- John M Boyce
- J.M. Boyce Consulting, LLC, 62 Sonoma Lane, Middletown, CT 06457, USA.
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Tamene A. What it takes to save lives: An assessment of water, sanitation, and hygiene facilities in temporary COVID-19 isolation and treatment centers of Southern Ethiopia: A mixed-methods evaluation. PLoS One 2021; 16:e0256086. [PMID: 34388184 PMCID: PMC8362949 DOI: 10.1371/journal.pone.0256086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 07/31/2021] [Indexed: 12/13/2022] Open
Abstract
Background Quality water, sanitation, and hygiene facilities act as barricades to the transmission of COVID-19 in health care facilities. These facilities ought to also be available, accessible, and functional in temporary treatment centers. Despite numerous studies on health care facilities, however, there is limited information on the status of WASH facilities in such centers. Methods The assessment of health care facilities for the COVID-19 response checklist and key informant interviews, were used for data collection. 35 treatment centers in Southern Ethiopia were surveyed. Eightkey informants were interviewed to gain an understanding of the WASH conditions in the treatment centers. The Quantitative data was entered using EPI-INFO 7 and exported to SPSS 20 for analysis. Results are presented using descriptive statistics. Open Code 4.02 was used for the thematic analysis of the qualitative data. Results Daily water supply interruptions occurred at 27 (77.1%) of the surveyed sites. Only 30 (85.72%) had bathrooms that were segregated for personnel and patients, and only 3 (3.57%) had toilets that were handicapped accessible. 20(57.2%) of the treatment centers did not have a hand hygiene protocol that satisfied WHO guidelines. In terms of infection prevention and control, 16 (45.71%) of the facilities lacked adequate personal protective equipment stocks. Between urban and rural areas, there was also a significant difference in latrine maintenance, hand hygiene protocol design and implementation, and incineration capacity. Conclusion The results reveal crucial deficiencies in the provision of WASH in the temporary COVID-19 treatment centers. Efforts to improve WASH should offer priority to hygiene service interventions to minimize the risk of healthcare-acquired infections. The sustainable provision of hygiene services, such as hand washing soap, should also be given priority.
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Affiliation(s)
- Aiggan Tamene
- Environmental Health Unit, School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossaena, Ethiopia
- * E-mail:
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10
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de Arriba-Fernández A, Molina-Cabrillana MJ, Serra Majem L. [Evolution of adherence to hand hygiene in health care professionals in a third level hospital in relation to the SARS-CoV-2 pandemic]. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2021; 34:214-219. [PMID: 33829723 PMCID: PMC8179943 DOI: 10.37201/req/150.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/20/2021] [Accepted: 02/22/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Proper hand hygiene is the main measure in the prevention and control of infection associated with healthcare. It describes how the pandemic period of 2020 has influenced the evolution of the degree of compliance with hand hygiene practices in health professionals at the Hospital Universitario Insular de Gran Canaria with respect to previous years. METHODS Descriptive cross-sectional study of direct observation on compliance with the five moments of hand hygiene in the 2018-2020 period. Adherence is described with the frequency distribution of the different moments in which it was indicated. RESULTS Total adherence has increased from 42.5% in 2018, to 47.6% in 2019, and 59.2% in 2020 (p <0.05). Total adherence was greater in the moments after contact with the patient (67%) than in the moments before contact (48%). The area with the highest adherence was dialysis (83%). There is a greater adherence in open areas than in hospitalization areas (65% vs 56%). Higher adherence was determined in physicians (73%) and nurses (74%), than in nursing assistants (50%) (p<0.05). CONCLUSIONS In 2020 there was an increase in adherence to hand hygiene compared to previous years. A higher percentage of adherence was determined in physicians and nurses than in nursing assistants. We consider that the current SARS-CoV-2 pandemic has played a relevant role in this increase in adherence.
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Affiliation(s)
- A de Arriba-Fernández
- Alejandro de Arriba-Fernández, Universidad de Las Palmas de Gran Canaria. Paseo Blas Cabrera Felipe "Físico", 310, Las Palmas Gran Canaria. Spain.
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Salcedo-Cifuentes M, Ordóñez-Hernández CA, Calvo-Soto AP. Cumplimiento de una estrategia de higiene de las manos en ambientes asistenciales. INVESTIGACIÓN EN ENFERMERÍA: IMAGEN Y DESARROLLO 2020. [DOI: 10.11144/javeriana.ie22.cehm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Introducción: Si bien la higiene de las manos es la medida más importante en la mitigación del riesgo biológico en ambientes hospitalarios, evidencia científica muestra un escaso cumplimiento de las recomendaciones entre los trabajadores asistenciales. Objetivo: Evaluar el cumplimiento de cinco dimensiones que fortalecen la estrategia de higiene de las manos para la prevención del riesgo biológico en ambientes asistenciales. Método: Estudio observacional, de corte transversal, en cinco instituciones prestadoras de servicios de salud. Se aplicó estadística descriptiva. Con el Test de Medianas se evaluó si había diferencias significativas entre el grupo de profesionales por institución de salud, considerando significante una p ≤ 0,05. El análisis finalizó con un análisis discriminante. Resultados: La representatividad estuvo en las instituciones hospitalarias de primer nivel en las cuales el personal de enfermería, seguido por los médicos, tuvo un mejor cumplimiento del protocolo de lavado de manos. Este porcentaje se vio impactado por el menor cumplimiento de suministro de insumos e infraestructura. Hay una perfecta diferenciación entre los resultados del municipio de Cali con relación al de Caicedonia, en contraste con los de Popayán, Buga y Buenaventura. Conclusión: Se encontró un incumplimiento del protocolo de higiene de las manos, con una calificación inaceptable para los factores de insumos/infraestructura y técnica de higiene de las manos, respectivamente.
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Phan HT, Zingg W, Tran HTT, Dinh APP, Pittet D. Sustained effects of a multimodal campaign aiming at hand hygiene improvement on compliance and healthcare-associated infections in a large gynaecology/obstetrics tertiary-care centre in Vietnam. Antimicrob Resist Infect Control 2020; 9:51. [PMID: 32276646 PMCID: PMC7146877 DOI: 10.1186/s13756-020-00712-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/26/2020] [Indexed: 12/22/2022] Open
Abstract
Background Hung Vuong Hospital (HVH) is a 900-bed maternity hospital in Ho-Chi-Minh-City, Vietnam. Due to low compliance, a quasi-experimental, observational study was conducted with the aim to improve hand hygiene. Methods A multimodal promotion strategy was established in 2010 and further developed towards ongoing, repetitive and inventive campaigns including patient participation. Hand hygiene compliance was monitored by direct observation and healthcare-associated infections (HAIs) by applying standard definitions. Results Between 2010 and 2018, a total of 43,711 hand hygiene opportunities were observed. Compliance improved from 21.5% (95%CI: 20.2–22.8%) in 2010 to 75.1% (73.9–76.2%) in 2018 (incidence rate ratio, IRR , 1.10; 95%CI, 1.10–1.11). This was achieved through increasing recourse to alcohol-based hand rubbing. A total of 554,720 women were admitted to HVH during the study period for 353,919 deliveries (198,679 vaginal; 155,240 by C-section) and 257,127 surgical procedures. The HAI-incidence decreased significantly from 1.10 episodes per 1000 patient-days in 2010 to 0.45 per 1000 patient-days in 2018 (IRR 0.85; 95%CI, 0.79–0.90). Significant improvement was observed also for surgical site infections after gynaecological surgery (IRR 0.95; 95%CI, 0.92–0.99) and endometritis after abortion (IRR 0.80; 95%CI, 0.68–0.93). Conclusions A multimodal strategy aiming at behaviour change significantly improved and sustained hand hygiene, which contributed to the reduction of healthcare-associated infections.
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Affiliation(s)
- Hang Thi Phan
- Infection control programme, Hung Vuong hospital, Ho Chi Minh City, Vietnam
| | - Walter Zingg
- Infection control programme and WHO collaborating centre on patient safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland.
| | - Hang Thi Thuy Tran
- Infection control programme, Hung Vuong hospital, Ho Chi Minh City, Vietnam
| | | | - Didier Pittet
- Infection control programme and WHO collaborating centre on patient safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland
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Jeanes A, Coen PG, Drey NS, Gould DJ. Moving beyond hand hygiene monitoring as a marker of infection prevention performance: Development of a tailored infection control continuous quality improvement tool. Am J Infect Control 2020; 48:68-76. [PMID: 31358420 PMCID: PMC7115327 DOI: 10.1016/j.ajic.2019.06.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/11/2019] [Accepted: 06/11/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Infection control practice compliance is commonly monitored by measuring hand hygiene compliance. The limitations of this approach were recognized in 1 acute health care organization that led to the development of an Infection Control Continuous Quality Improvement tool. METHODS The Pronovost cycle, Barriers and Mitigation tool, and Hexagon framework were used to review the existing monitoring system and develop a quality improvement data collection tool that considered the context of care delivery. RESULTS Barriers and opportunities for improvement including ambiguity, consistency and feasibility of expectations, the environment, knowledge, and education were combined in a monitoring tool that was piloted and modified in response to feedback. Local adaptations enabled staff to prioritize and monitor issues important in their own workplace. The tool replaced the previous system and was positively evaluated by auditors. Challenges included ensuring staff had time to train in use of the tool, time to collect the audit, and the reporting of low scores that conflicted with a target-based performance system. CONCLUSIONS Hand hygiene compliance monitoring alone misses other important aspects of infection control compliance. A continuous quality improvement tool was developed reflecting specific organizational needs that could be transferred or adapted to other organizations.
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Affiliation(s)
- Annette Jeanes
- Infection Control Department, University College London Hospitals, London, United Kingdom.
| | - Pietro G Coen
- Infection Division, Maples House, London, United Kingdom
| | - Nicolas S Drey
- School of Health Studies, University of London, London, United Kingdom
| | - Dinah J Gould
- School of healthcare Sciences, Cardiff University, Cardiff, United Kingdom
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Engdaw GT, Gebrehiwot M, Andualem Z. Hand hygiene compliance and associated factors among health care providers in Central Gondar zone public primary hospitals, Northwest Ethiopia. Antimicrob Resist Infect Control 2019; 8:190. [PMID: 31788237 PMCID: PMC6880540 DOI: 10.1186/s13756-019-0634-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/24/2019] [Indexed: 01/17/2023] Open
Abstract
Background Poor hand hygiene compliance is one in all the leading contributory factors to healthcare-associated infections. This is an important source of complications across the continuum of care and poses a serious threat to people admitted to hospitals. However, the magnitude and associated factors of hand hygiene compliance in public primary hospitals were not well investigated in Ethiopia. Therefore, this study was conducted to assess hand hygiene compliance and associated factors among health care providers in Central Gondar Zone public primary hospitals, Northwest Ethiopia. Methods An Institutional based cross-sectional study was conducted from March to April 2019 among health care providers. The data were collected using self-administered questionnaires and observational checklists. Using Epi Info 3.1, data was entered and analyzed using SPSS version 23. The data were analyzed using descriptive statistics and logistic regression models. A p-value less than 0.05 with 95% confidence interval was used to declare statistical significance. Results Of 335 study participants, 50 (14.9%), had good hand hygiene compliance. Training on hand hygiene (AOR = 8.07, 95%CI: 2.91, 22.39), availability of adequate soap and water for hand hygiene (AOR = 5.10, 95%CI: 1.93, 13.52), availability of alcohol-based hand rub (AOR = 3.23, 95%CI: 1.32, 7.92), knowledge about hand hygiene (AOR = 6.74, 95%CI: 2.96, 15.34) and attitude towards hand hygiene (AOR = 2.15, 95%CI: 1.04, 4.46) were factors associated with hand hygiene compliance. Conclusion The overall level of hand hygiene compliance among health care providers was poor. Training, availability of adequate soap and water, availability of alcohol-based hand rub, knowledge on hand hygiene, and attitude of health care providers were significantly associated with hand hygiene compliance.
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Affiliation(s)
- Garedew Tadege Engdaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulat Gebrehiwot
- Department of Environmental and Occupational Health and Safety, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zewudu Andualem
- Department of Environmental and Occupational Health and Safety, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Abstract
Although substantial improvements in hand hygiene practices have occurred in recent years, many health care facilities continue to encounter challenges in achieving and maintaining high levels of hand hygiene compliance. Issues of current interest include the optimum dose of alcohol-based handrub (ABHR) that should be applied, the impact of hand size and alcohol-based handrub dry times have on efficacy, and ideal hand hygiene technique. There is a need to determine which additional promotional activities can augment improvements in hand hygiene that are achieved by implementing the multimodal improvement strategy recommended by the World Health Organization. Monitoring hand hygiene performance and providing personnel with feedback on their performance are essential elements of successful improvement programs. Further research is needed to establish the most effective methods of providing feedback. Additional studies are needed to optimize strategies for performing direct observation of hand hygiene compliance, and to determine the role of supplementing direct observations using automated monitoring systems.
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