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Schutte M, van Mansfeld R, de Vries R, Dekker M. Determinants of compliance with infection prevention measures by physicians: a scoping review. J Hosp Infect 2024; 153:30-38. [PMID: 39214255 DOI: 10.1016/j.jhin.2024.08.011] [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: 05/31/2024] [Revised: 08/05/2024] [Accepted: 08/17/2024] [Indexed: 09/04/2024]
Abstract
Despite evidence that application of infection prevention measures can reduce healthcare-associated infections, compliance with these measures is low, especially among physicians. Intervention effects often do not sustain. An overview of determinants for physicians' infection prevention behaviour and successful behaviour change strategies is lacking. The aim of this review was to identify what determinants influence physicians' infection prevention behaviour, what strategies to improve compliance have been explored, and whether theories, models, and frameworks from implementation science have been used in these studies. A literature search was performed in PubMed, Embase, APA PsycInfo and Web of Science up to June 2nd, 2023, in collaboration with a medical information specialist. All study types focusing on infection prevention behaviour of physicians in high-income countries were included. Data on determinants and strategies was extracted; determinants were categorized into the Theoretical Domains Framework (TDF). Fifty-six articles were included. The TDF domains 'environmental context and resources', 'social influences', 'beliefs about consequences', 'memory, attention and decision-making', 'knowledge', and 'skills' were found most relevant. The prevailing determinant covers a theme outside the TDF: socio-demographic factors. Sustainable interventions are multimodal approaches that at least include feedback, education, and a champion. Theories, models, and frameworks have rarely been used to guide implementation strategy development. In conclusion, it was found that intervention studies rarely specify the determinants that they aim to address and they lack theoretical underpinning. Future initiatives should combine knowledge about determinants with implementation science to develop theory-based interventions tailored to determinants.
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Affiliation(s)
- M Schutte
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - R van Mansfeld
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - R de Vries
- Medical Library, Vrije Universiteit, Amsterdam, The Netherlands
| | - M Dekker
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Gurbuz K, Das K, Demir M, Suntur BM, Ozlu O, Basaran A, Cil MK, Golbol A. Impacts of intelligent monitoring technology installation and additional modalities on hand hygiene compliance in a burn center: A quasi-experimental longitudinal trial. Burns 2024; 50:1307-1314. [PMID: 38458960 DOI: 10.1016/j.burns.2024.02.020] [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: 08/24/2023] [Revised: 01/23/2024] [Accepted: 02/26/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND The increasing development of intelligent technologies for hand hygiene (HH) compliance audit has the potential to create an alternative to direct observation (DO), which is still considered the gold standard but has disadvantages such as lack of standardized monitoring practices, Hawthorne effect, insufficient sample size, and time/resource consumption. We aimed to share our preliminary results on the impacts of intelligent monitoring technology installation (IMTI) and additional modalities on healthcare workers' (HCWs') HH compliance in a Burn Center, according to the "5 Moments of HH" concept defined by the World Health Organization (WHO). METHODS A quasi-experimental longitudinal trial was conducted over eleven months.The first phase of the three-stage study evaluated basic HH compliances obtained by DO. The system-defined HH performances, which IMTI recorded, were assessed in the second phase. Finally, the effect of IMTI and additional modalities was determined in the third stage. RESULTS 15202 HH events were performed by 41 HCWs, and a total of 20095 HH opportunities were observed. Four hundred fifty-five opportunities were in the preinstallation phase, and 19640 were during the total post-installation period. IMTIdefined performance rates in both Phase 2 (71.2%) and Phase 3 (80.5%) were generally considerably higher than HH compliances obtained from DO (58.5%). Nurses, physical therapy /anesthesia technicians, and housekeeping personnel showed significant increases, which was insignificant in physicians in phase 2. Meanwhile, a sustained increase was observed regarding IMTI and additional modalities of HH compliance of all HCWs in Phase 3. CONCLUSION IMTI has significantly increased HH performance rates. Furthermore, combining the IMTI with additional modalities as components of a multimodal strategy recommended by WHO appears to affect the sustainability of the increasing trend of HCWs' HH compliance.
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Affiliation(s)
- Kayhan Gurbuz
- University of Health Sciences, Adana City Training and Research Hospital, Department of General Surgery, Burn Center, Adana, Turkiye.
| | - Koray Das
- University of Health Sciences, Adana City Training and Research Hospital, Department of General Surgery, Burn Center, Adana, Turkiye
| | - Mete Demir
- University of Health Sciences, Adana City Training and Research Hospital, Department of General Surgery, Burn Center, Adana, Turkiye
| | - Bedia Mutay Suntur
- University of Health Sciences, Adana City Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Adana, Turkiye
| | - Ozer Ozlu
- University of Health Sciences, Adana City Training and Research Hospital, Department of General Surgery, Burn Center, Adana, Turkiye
| | - Abdulkadir Basaran
- University of Health Sciences, Adana City Training and Research Hospital, Department of General Surgery, Burn Center, Adana, Turkiye
| | - Merve Kilic Cil
- University of Health Sciences, Adana City Training and Research Hospital, Department of Pediatric Infectious Diseases, Adana, Turkiye
| | - Abdullah Golbol
- University of Health Sciences, Adana City Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Adana, Turkiye
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Gould D, Hawker C, Drey N, Purssell E. Should automated electronic hand-hygiene monitoring systems be implemented in routine patient care? Systematic review and appraisal with Medical Research Council Framework for Complex Interventions. J Hosp Infect 2024; 147:180-187. [PMID: 38554805 DOI: 10.1016/j.jhin.2024.03.012] [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: 01/23/2024] [Revised: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 04/02/2024]
Abstract
Manual hand-hygiene audit is time-consuming, labour-intensive and inaccurate. Automated hand-hygiene monitoring systems (AHHMSs) offer advantages (generation of standardized data, avoidance of the Hawthorne effect). World Health Organization Guidelines for Hand Hygiene published in 2009 suggest that AHHMSs are a possible alternative. The objective of this review was to assess the current state of the literature for AHHMSs and offer recommendations for use in real-world settings. This was a systematic literature review, and publications included were from the time that PubMed commenced until 19th November 2023. Forty-three publications met the criteria. Using the Medical Research Council's Framework for Developing and Evaluating Complex Interventions, two were categorized as intervention development studies. Thirty-nine were evaluations. Two described implementation in real-world settings. Most were small scale and short duration. AHHMSs in conjunction with additional intervention (visual or auditory cue, performance feedback) could increase hand hygiene compliance in the short term. Impact on infection rates was difficult to determine. In the few publications where costs and resources were considered, time devoted to improving hand hygiene compliance increased when an AHHMS was in use. Health workers' opinions about AHHMSs were mixed. In conclusion, at present too little is known about the longer-term advantages of AHHMSs to recommend uptake in routine patient care. Until more longer-term accounts of implementation (over 12 months) become available, efforts should be made to improve direct observation of hand hygiene compliance to improve its accuracy and credibility. The Medical Research Council Framework could be used to categorize other complex interventions involving use of technology to prevent infection to help establish readiness for implementation.
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Affiliation(s)
- D Gould
- Independent Consultant, London, UK
| | - C Hawker
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - N Drey
- School of Health & Psychological Sciences, Department of Nursing, City University, London, UK
| | - E Purssell
- Faculty of Health, Medicine and Social Care, School of Nursing and Midwifery, Anglia Ruskin University, Chelmsford, UK.
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Gaube S, Walton K, Kleine AK, Däumling S, Rohrmeier C, Müller S, Bonrath E, Schneider-Brachert W. Examining outpatients' hand hygiene behaviour and its relation to COVID-19 infection prevention measures. J Hosp Infect 2023; 141:55-62. [PMID: 37634601 DOI: 10.1016/j.jhin.2023.08.013] [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: 05/17/2023] [Revised: 08/03/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND The increasing demand for outpatient care is associated with a higher risk of infection transmission in these settings. However, there is limited research on infection prevention and control practices in ambulatory clinics, and none focuses on patients. AIM To examine outpatients' hand hygiene behaviours, their determinants, and their associations with other infection prevention measures during the COVID-19 pandemic. METHODS We observed the hand hygiene behaviour of one cohort of patients in one outpatient clinic and surveyed a separate sample in five clinics about their hand hygiene practice in outpatient facilities. A questionnaire based on the Theoretical Domains Framework (TDF) was used to examine predictors of the behaviour. Moreover, patients indicated their compliance with COVID-19 infection prevention measures, vaccination status, disease risk perception, and vaccine hesitancy. FINDINGS Observed hand hygiene rates among 618 patients were low (12.8%), while 67.3% of the 300 surveyed patients indicated sanitizing their hands upon entering the clinic. The TDF domains 'memory, attention, and decision processes' and 'emotions' significantly predicted both current (today's) and general hand hygiene behaviour in outpatient clinics. Hand hygiene behaviour and compliance with COVID-19 infection prevention showed a positive association; however, no significant connection was found with patients' vaccination status, suggesting different behavioural motivators. CONCLUSION Hand hygiene among outpatients should be improved through interventions focusing on helping patients remember to clean their hands. More research on infection prevention in outpatient facilities is needed to ensure patient safety.
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Affiliation(s)
- S Gaube
- Global Business School for Health, University College London, London, UK.
| | - K Walton
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - A-K Kleine
- LMU Center for Leadership and People Management, LMU Munich, Munich, Germany
| | - S Däumling
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - C Rohrmeier
- Faculty of Medicine, University of Regensburg, Regensburg, Germany; HNO-Gemeinschaftspraxis, Straubing, Germany
| | - S Müller
- Clinic and Polyclinic for Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany; MKG-Praxis im Turm, Straubing, Germany
| | - E Bonrath
- Praxis für Chirurgie & Handchirurgie, Regensburg, Germany
| | - W Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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Fujita R, Arbogast JW, Yoshida R, Hori S. A multi-centre study of the effects of direct observation of hand hygiene practices on alcohol-based handrub consumption. Infect Prev Pract 2022; 4:100256. [PMID: 36387608 PMCID: PMC9646915 DOI: 10.1016/j.infpip.2022.100256] [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: 07/25/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction The World Health Organization recommends monitoring alcohol-based handrub (ABHR) consumption and direct observation of hand hygiene practices to ensure compliance. In Japan monitoring of ABHR consumption is widely performed. However, direct observation is not common, particularly in small facilities and non-acute-care facilities. Hence, the current study aimed to evaluate the longitudinal effects of direct observation of hand hygiene practices and monitoring of ABHR consumption with provision of feedback to healthcare personnel on ABHR consumption and hand hygiene compliance. Methods We conducted a 4-year prospective intervention study. Monitoring of ABHR consumption and direct observation of hand hygiene practices with monthly feedback to healthcare personnel was implemented in 17 facilities. These consisted of 11 acute-care facilities of varying sizes and six non-acute-care facilities. A generalized linear mixed model analysis was performed to assess factors associated with ABHR consumption. Results All facilities implemented ABHR consumption monitoring within one month of starting the study. However, the mean time required to implement direct observation of hand hygiene practices was 24.7 (±19.1) months. The ABHR consumption increased significantly (P<0.0001) in all medical facilities after implementing the direct observation. Multivariable regression analysis showed the hospital ward type, duration of ABHR consumption monitoring, and duration of direct observation of hand hygiene practices were independently associated with ABHR consumption. Conclusions Direct observation of hand hygiene practices with feedback should be implemented more widely in combination with ABHR consumption monitoring to help increase hand hygiene compliance.
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Affiliation(s)
- Retsu Fujita
- Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | | | - Rika Yoshida
- Division of Infection Prevention and Control, Postgraduate School, Tokyo Healthcare University, Tokyo, Japan
| | - Satoshi Hori
- Department of Infection Control Science, Juntendo University School of Medicine, Tokyo, Japan
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Barbon HCV, Fermin JL, Kee SL, Tan MJT, AlDahoul N, Karim HA. Going Electronic: Venturing Into Electronic Monitoring Systems to Increase Hand Hygiene Compliance in Philippine Healthcare. Front Pharmacol 2022; 13:843683. [PMID: 35250592 PMCID: PMC8892004 DOI: 10.3389/fphar.2022.843683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 02/01/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Jamie Ledesma Fermin
- Department of Electronics Engineering, University of St. La Salle, Bacolod, Philippines
| | - Shaira Limson Kee
- Department of Natural Sciences, University of St. La Salle, Bacolod, Philippines
| | - Myles Joshua Toledo Tan
- Department of Natural Sciences, University of St. La Salle, Bacolod, Philippines
- Department of Chemical Engineering, University of St. La Salle, Bacolod, Philippines
- *Correspondence: Myles Joshua Toledo Tan, ; Hezerul Abdul Karim,
| | - Nouar AlDahoul
- Faculty of Engineering, Multimedia University, Cyberjaya, Malaysia
| | - Hezerul Abdul Karim
- Faculty of Engineering, Multimedia University, Cyberjaya, Malaysia
- *Correspondence: Myles Joshua Toledo Tan, ; Hezerul Abdul Karim,
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Zhang Y, Chen X, Lao Y, Qiu X, Liu K, Zhuang Y, Gong X, Wang P. Effects of the Implementation of Intelligent Technology for Hand Hygiene in Hospitals: A Systematic Review and Meta-analysis (Preprint). J Med Internet Res 2022; 25:e37249. [DOI: 10.2196/37249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 12/12/2022] [Accepted: 03/19/2023] [Indexed: 03/20/2023] Open
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Xu Q, Liu Y, Cepulis D, Jerde A, Sheppard RA, Reichle W, Scott L, Oppy L, Stevenson G, Bishop S, Clifford SP, Liu P, Kong M, Huang J. Hand Hygiene Behaviours Monitored by an Electronic System in the Intensive Care Unit-A Prospective Observational Study. J Hosp Infect 2022; 123:126-134. [PMID: 35122887 PMCID: PMC9113830 DOI: 10.1016/j.jhin.2022.01.017] [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: 12/29/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Hand hygiene (HH) compliance is hard to improve and underlying behaviours are not clearly understood among healthcare workers. AIM To study healthcare workers' HH behaviours. METHODS Prospective observational study. Sanibit electronic hand hygiene system was installed in a 10-bed surgical intensive care unit that automatically detected HH opportunities when healthcare workers entered or exited a patient room, and tracked healthcare worker's HH compliance. HH compliance rate and patient contact time were calculated and analyzed at both the ICU and individual levels over time. FINDINGS A total of 27,692 HH opportunities were recorded during this 6-month trial period. The HH compliance rate was significantly higher when healthcare workers exited patient rooms than when they entered rooms (37.3% vs. 26.1%, P < 0.001). The full, partial, and total HH compliance rates of quick in-out of room (in room less than 3 seconds) events were significantly lower than those of long in-out room (in room more than 30 seconds) events (23.45% vs 32.77%, 21.44% vs 35.03%, and 44.88% vs 67.81% respectively) (P-value <0.001). There was also significantly differences in HH compliance among individual healthcare workers (P < 0.001). No statistically significant difference was found in overall HH compliance rate and patient contact time over hours of the day or days of the week except partial HH compliance rates. CONCLUSION Patterns of healthcare workers' HH behaviors are complex and variable, which could facilitate targeted and personalized interventions to improve HH compliance.
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Affiliation(s)
- Qian Xu
- Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | - Yang Liu
- Microsensor Labs, LLC, Chicago, IL, USA.
| | | | - Ann Jerde
- Clinical Trials Unit, University of Louisville, Louisville, KY, USA
| | | | | | - LaShawn Scott
- Department of Infection Control and Prevention, University of Louisville Health, Louisville, KY, USA
| | - Leah Oppy
- Department of Infection Control and Prevention, University of Louisville Health, Louisville, KY, USA
| | - Gina Stevenson
- Department of Infection Control and Prevention, University of Louisville Health, Louisville, KY, USA
| | - Sarah Bishop
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Sean P Clifford
- Department of Anesthesiology & Perioperative Medicine, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Peng Liu
- Microsensor Labs, LLC, Chicago, IL, USA
| | - Maiying Kong
- Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA.
| | - Jiapeng Huang
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), Department of Medicine, University of Louisville, Louisville, KY, USA; Department of Anesthesiology & Perioperative Medicine, School of Medicine, University of Louisville, Louisville, KY, USA; Department of Cardiovascular & Thoracic Surgery, School of Medicine, University of Louisville, Louisville, USA; Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, KY, USA; Department of Pharmacology & Toxicology, School of Medicine, University of Louisville, Louisville, USA.
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Park SY, Park S, Hwang BS, Lee E, Kim TH, Won S. Appropriate number of observations for determining hand hygiene compliance among healthcare workers. Antimicrob Resist Infect Control 2021; 10:167. [PMID: 34857040 PMCID: PMC8638267 DOI: 10.1186/s13756-021-01035-1] [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: 06/25/2021] [Accepted: 11/17/2021] [Indexed: 11/20/2022] Open
Abstract
We sought to determine the minimum number of observations needed to determine hand hygiene (HH) compliance among healthcare workers. The study was conducted at a referral hospital in South Korea. We retrospectively analyzed the result of HH monitoring from January to December 2018. HH compliance was calculated by dividing the number of observed HH actions by the total number of opportunities. Optimal HH compliance rates were calculated based on adherence to the six-step technique recommended by the World Health Organization. The minimum number of required observations (n) was calculated by the following equation using overall mean value (ρ), absolute precision (d), and confidence interval (CI) (1 − α) [the equation: \documentclass[12pt]{minimal}
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\begin{document}$${\text{n}} \ge Z_{\alpha /2}^{2} \times \rho \times \left( {1 - \rho } \right)/d^{2}$$\end{document}n≥Zα/22×ρ×1-ρ/d2]. We considered ds of 5%, 10%, 20%, and 30%, with CIs of 99%, 95%, and 90%. During the study period, 8791 HH opportunities among 1168 healthcare workers were monitored. Mean HH compliance and optimal HH compliance rates were 80.3% and 59.7%, respectively. The minimum number of observations required to determine HH compliance rates ranged from 2 (\documentclass[12pt]{minimal}
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\begin{document}$$d$$\end{document}d: 30%, CI: 90%) to 624 (\documentclass[12pt]{minimal}
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\begin{document}$$d$$\end{document}d: 5%, CI: 99%), and that for optimal HH compliance ranged from 5 (\documentclass[12pt]{minimal}
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\begin{document}$$d$$\end{document}d: 30%, CI: 90%) to 642 (\documentclass[12pt]{minimal}
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\begin{document}$$d$$\end{document}d: 5%, CI: 99%). Therefore, we found that our hospital required at least five observations to determine optimal HH compliance.
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Affiliation(s)
- Se Yoon Park
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University, Seoul Hospital, Soonchunhyang University College of Medicine, 59, Daesagwan-ro, Yongsan-gu, Seoul, 04401, Republic of Korea.
| | - Suyeon Park
- Department of Biostatistics, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.,Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Beom Seuk Hwang
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Eunjung Lee
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University, Seoul Hospital, Soonchunhyang University College of Medicine, 59, Daesagwan-ro, Yongsan-gu, Seoul, 04401, Republic of Korea
| | - Tae Hyong Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University, Seoul Hospital, Soonchunhyang University College of Medicine, 59, Daesagwan-ro, Yongsan-gu, Seoul, 04401, Republic of Korea
| | - Sungho Won
- Department of Public Health Science, Seoul National University, Seoul, 08826, Republic of Korea.
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Wang C, Jiang W, Yang K, Yu D, Newn J, Sarsenbayeva Z, Goncalves J, Kostakos V. Electronic Monitoring Systems for Hand Hygiene: Systematic Review of Technology. J Med Internet Res 2021; 23:e27880. [PMID: 34821565 PMCID: PMC8663600 DOI: 10.2196/27880] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 09/04/2021] [Accepted: 10/04/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hand hygiene is one of the most effective ways of preventing health care-associated infections and reducing their transmission. Owing to recent advances in sensing technologies, electronic hand hygiene monitoring systems have been integrated into the daily routines of health care workers to measure their hand hygiene compliance and quality. OBJECTIVE This review aims to summarize the latest technologies adopted in electronic hand hygiene monitoring systems and discuss the capabilities and limitations of these systems. METHODS A systematic search of PubMed, ACM Digital Library, and IEEE Xplore Digital Library was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were initially screened and assessed independently by the 2 authors, and disagreements between them were further summarized and resolved by discussion with the senior author. RESULTS In total, 1035 publications were retrieved by the search queries; of the 1035 papers, 89 (8.60%) fulfilled the eligibility criteria and were retained for review. In summary, 73 studies used electronic monitoring systems to monitor hand hygiene compliance, including application-assisted direct observation (5/73, 7%), camera-assisted observation (10/73, 14%), sensor-assisted observation (29/73, 40%), and real-time locating system (32/73, 44%). A total of 21 studies evaluated hand hygiene quality, consisting of compliance with the World Health Organization 6-step hand hygiene techniques (14/21, 67%) and surface coverage or illumination reduction of fluorescent substances (7/21, 33%). CONCLUSIONS Electronic hand hygiene monitoring systems face issues of accuracy, data integration, privacy and confidentiality, usability, associated costs, and infrastructure improvements. Moreover, this review found that standardized measurement tools to evaluate system performance are lacking; thus, future research is needed to establish standardized metrics to measure system performance differences among electronic hand hygiene monitoring systems. Furthermore, with sensing technologies and algorithms continually advancing, more research is needed on their implementation to improve system performance and address other hand hygiene-related issues.
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Affiliation(s)
- Chaofan Wang
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Weiwei Jiang
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Kangning Yang
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Difeng Yu
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Joshua Newn
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Zhanna Sarsenbayeva
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Jorge Goncalves
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Vassilis Kostakos
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
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11
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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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12
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NAZZİWA A, LWERE K, ANKARALI S, ANKARALI H. Knowledge About Hand Hygiene among Medical Students and Nursing Students in Masaka Regional Referral Hospital. DÜZCE ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2021. [DOI: 10.33631/duzcesbed.887338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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