Anesthesia as a Risk for Health Care Acquired Infections

Video-based automatic hand hygiene detection for operating rooms using 3D convolutional neural networks

Hand hygiene among anesthesia personnel is important to prevent hospital-acquired infections in operating rooms; however, an efficient monitoring system remains elusive. In this study, we leverage a deep learning approach based on operating room videos to detect alcohol-based hand hygiene actions of anesthesia providers. Videos were collected over a period of four months from November, 2018 to February, 2019, at a single operating room. Additional data was simulated and added to it. The proposed algorithm utilized a two-dimensional (2D) and three-dimensional (3D) convolutional neural networks (CNNs), sequentially. First, multi-person of the anesthesia personnel appearing in the target OR video were detected per image frame using the pre-trained 2D CNNs. Following this, each image frame detection of multi-person was linked and transmitted to a 3D CNNs to classify hand hygiene action. Optical flow was calculated and utilized as an additional input modality. Accuracy, sensitivity and specificity were evaluated hand hygiene detection. Evaluations of the binary classification of hand-hygiene actions revealed an accuracy of 0.88, a sensitivity of 0.78, a specificity of 0.93, and an area under the operating curve (AUC) of 0.91. A 3D CNN-based algorithm was developed for the detection of hand hygiene action. The deep learning approach has the potential to be applied in practical clinical scenarios providing continuous surveillance in a cost-effective way.

Sleep safe in clean hands: Improving hand hygiene compliance in the operating room through education and increased access to hand hygiene products

BACKGROUND

Hand hygiene compliance is low among anesthesia providers in the operating room, which places patients at risk of preventable infections. The goal of this project was to improve hand hygiene compliance by educating anesthesia providers on the World Health Organization's 5 indications for hand hygiene, and increasing access to hand hygiene products in the operating room.

METHODS

Observations of hand hygiene in the operating room took place in 3 phases: preimplementation, postimplementation, and 60 days postimplementation.

RESULTS

The results showed significant improvements in compliance for each of the 5 indications for hand hygiene as well as overall compliance. Each of the 3 phases of anesthesia demonstrated significant improvement as well. The results also showed a significant decrease in both glove use and use of the portable hand sanitizer device.

DISCUSSION

Education and monitoring of hand hygiene among anesthesia providers in the operating room can improve hand hygiene compliance.

CONCLUSIONS

Although the use of the portable device declined, further studies could focus on observing single anesthesia providers instead of a preceptor/student combination, and also examine proximity to hand hygiene products in relation to compliance.