Hand hygiene compliance surveillance with time series anomaly detection

Difference between self-reported adherence to standard precautions and surveillance and factors influencing observed adherence: a quantile regression approach

Background

Standard precautions are minimum healthcare-associated infection prevention practices applied in all healthcare settings. The aim of this study was to investigate adherence to standard precautions using a survey and surveillance. Factors affecting observed adherence to standard precautions were also determined.

Methods

This cross-sectional observational study included 163 clinical nurses who were directly involved in patient care. Differences in adherence according to investigative methods are represented as a boxplot. Quantile regression was used to identify factors affecting observed adherence, including organizational factors (such as department, safety environment, and patient safety climate) and personal factors (such as knowledge and awareness). Stata SE version 14.2 was used for all statistical analyses.

Results

The observed adherence to standard precautions was 76.8 out of 100, whereas the self-reported adherence was approximately 95. Hand hygiene adherence received the lowest score of less than 70. Factors influencing observed adherence were self-reported adherence (p = 0.043) in 25% and 50% quantiles, work experience (p = 0.002) in the 25% quantile, and working department (p = 0.030) in the 50% quantile. There were no significant factors in the 75% quantile.

Conclusion

Inadequate adherence to standard precautions might increase healthcare-associated infections. Thus, an organizational environment such as nurse staffing needs to be established so that clinical nurses with high competency can comply with standard precautions in clinical settings.

Comparison of two electronic hand hygiene monitoring systems in promoting hand hygiene of healthcare workers in the intensive care unit

Background

Hand hygiene (HH) is the cornerstone of infection control, and the promotion of HH is the focus of the world. The study aims to compare the role of two different types of electronic hand hygiene monitoring systems (EHHMSs) in promoting HH of healthcare workers (HCWs) in the intensive care unit (ICU).

Methods

In a 16-bed ICU of a general tertiary hospital in Shenzhen, the research was divided into three stages with interrupted time series (ITS) design. In the first stage, the direct observation method was used to monitor and feed back the HH compliance rate of HCWs monthly. In the second stage, the type1 EHHMS was applied to monitor and feed back the individual number of HH events monthly. In the third stage, the type2 EHHMS with a function of instant reminder and feedback was employed, and the personal HH compliance rates were fed back monthly. Meanwhile, direct observation continued in the last two stages.

Results

In the second stage, The HH compliance rate increased. However, there was no significant difference in the trajectory of the rate compared with the first stage. In the first month of the third stage, the HH compliance rate increased by 12.324% immediately and then ascended by 1.242% over time. The number of HH events per bed day and HH products’ consumption per bed day were consistent with the change of HH compliance rate observed.

Conclusion

Monitoring and feedback can improve the HH of HCWs. The EHHMS, with the function of real-time reminders and feedback, has a more noticeable effect on promoting HH.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-020-05748-3.