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Heesters V, van Zanten HA, Heijstek V, Te Pas AB, Witlox RSGM. Record, reflect and refine: using video review as an initiative to improve neonatal care. Pediatr Res 2024:10.1038/s41390-024-03083-w. [PMID: 38356026 DOI: 10.1038/s41390-024-03083-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/21/2023] [Accepted: 01/27/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND The goal of every medical team is to provide optimal care for their patients. We aimed to use video review (VR) sessions to identify and address areas for improvement in neonatal care. METHODS For nine months, neonatal procedures (stabilization at birth, intubations and sterile line insertions) were video recorded and reviewed with the neonatal care providers. Action research was used to identify and address areas for improvement which were categorized as (1) protocol/equipment adjustments, (2) input for research, (3) aspects of variety, or (4) development of educational material or training programs. RESULTS Eighteen VR sessions were organized with a mean(SD) of 17(5) staff members participating. In total, 120 areas for improvement were identified and addressed, of which 84/120 (70%) were categorized as aspects of variety, 20/120 (17%) as development of educational material or training programs, 10/120 (8%) as protocol/equipment adjustments, and 6/120 (5%) as input for research. The areas for improvement were grouped in themes per category, including sterility, technique, equipment, communication, teamwork, parents' perspective and ventilation. CONCLUSION Our study showed that regularly organized VR empowered healthcare providers to identify and address a large variety of areas for improvement, contributing to continuous learning and improvement processes. IMPACT Video review empowered healthcare providers to identify areas for improvement in neonatal care Video review gave providers the opportunity to address identified areas for improvement, either by enhancing the application of external evidence (i.e. guidelines), learning from individual clinical expertise or strengthening resilience and teamwork Embedding regularly organized video review sessions allowed for continuous monitoring of care by providers, which can be beneficial for creating ongoing learning and improvement processes The structured pathways, supporting implementation of changes that were proposed based on the video review sessions, could help other centers make use of the potential video review has to offer.
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Affiliation(s)
- Veerle Heesters
- Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.
| | - Henriette A van Zanten
- Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands
| | - Veerle Heijstek
- Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands
| | - Arjan B Te Pas
- Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands
| | - Ruben S G M Witlox
- Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands
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2
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Pawlicki Ł, Fotyga A, Rewieński J, Groth M, Kulas Ł, Fotyga G. Wireless Body Area Network for Preventing Self-Inoculation Transmission of Respiratory Viral Diseases. SENSORS (BASEL, SWITZERLAND) 2023; 23:2042. [PMID: 36850640 PMCID: PMC9959337 DOI: 10.3390/s23042042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
This paper proposes an idea of Wireless Body Area Networks (WBANs) based on Bluetooth Low-Energy (BLE) standards to recognize and alarm a gesture of touching the face, and in effect, to prevent self-inoculation of respiratory viral diseases, such as COVID-19 or influenza A, B, or C. The proposed network comprises wireless modules placed in bracelets and a necklace. It relies on the received signal strength indicator (RSSI) measurements between the bracelet and necklace modules. The measured signal is cleared of noise using the exponential moving average (EMA). Next, we use a classification algorithm based on a Least-Squares Support Vector Machine (LSSVM) in order to detect facial touches. When the results of the classification indicate that the hand is moving toward the face, an alarm is sent through the neck module and the vibrator embedded in the wrist module is switched on. Based on the performed tests, it can be concluded that the proposed solution is characterized by high accuracy and reliability. It should be useful, especially for individuals who are regularly exposed to the risk of respiratory infections.
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McKay KJ, Li C, Sotomayor-Castillo C, Ferguson PE, Wyer M, Shaban RZ. Health care workers' experiences of video-based monitoring of hand hygiene behaviors: a qualitative study. Am J Infect Control 2023; 51:83-88. [PMID: 35339623 DOI: 10.1016/j.ajic.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hand hygiene is key to preventing health care-associated infections. Human observation is the gold standard for measuring compliance, but its utility is increasingly being questioned with calls for the use of video monitoring approaches. The utility of video-based systems to measure compliance according to the WHO 5 moments is largely unexamined, as is its acceptability amongst health care workers (HCW) and patients. This study examined HCW acceptability of video monitoring for hand hygiene auditing. METHODS Following trial of a video monitoring system (reported elsewhere), 5 participating HCW attended 2 in-depth group interviews where they reviewed the footage and explored responses to the approach. Transcripts were analyzed using thematic analysis. RESULTS Four themes were identified: 1) Fears; 2) Concerns for patients; 3) Changes to feedback; and 4) Behavioral responses to the cameras. HCWs expressed fears of punitive consequences, data security, and confidentiality. For patients, HCWs raised issues regarding invasion of privacy, ethics, and consent. HCWs suggested that video systems may result in less immediate feedback but also identified potential to use the footage for feedback. They also suggested that the Hawthorne Effect was less potent with video systems than human observation. CONCLUSIONS The acceptability of video monitoring systems for hand hygiene compliance is complex and has the potential to complicate practical implementation. Additionally, exploration of the acceptability to patients is warranted. CHECKLIST COREQ.
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Affiliation(s)
- Katherine J McKay
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia.
| | - Cecilia Li
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia
| | - Cristina Sotomayor-Castillo
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia
| | - Patricia E Ferguson
- Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia; Centre for Infectious Diseases and Microbiology, Westmead Hospital, Western Sydney Local Health District, Westmead, NSW, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia
| | - Mary Wyer
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, Australia
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4
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Using video-based surveillance for monitoring hand hygiene compliance according to the World Health Organization (WHO) Five Moments framework: A pragmatic trial. Infect Control Hosp Epidemiol 2022; 44:721-727. [DOI: 10.1017/ice.2021.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Objective:
To examine the utility of video-based monitoring systems (VMSs) for auditing hand hygiene compliance according to the World Health Organization (WHO) Five Moments.
Design:
Pragmatic quasi-experimental observation trial.
Setting:
The New South Wales Biocontainment Centre, Westmead, New South Wales, Australia.
Participants:
Volunteer healthcare workers (HCWs).
Method:
Six high-fidelity simulations were recorded and subsequently assessed for their ability to audit hand hygiene compliance according to the WHO Five Moments for hand hygiene criteria using tools provided by the National Hand Hygiene Initiative (NHHI).
Results:
In total, 206 minutes of recorded footage were reviewed in 120 minutes, yielding 111 moments. Overall HCW hand hygiene compliance was 88% according to the WHO Five Moments framework. The cost per moment was $0.91 AUD ($0.66 USD) and the time required per moment was 64 seconds.
Conclusions:
Auditing of hand hygiene compliance according to all 5 of the WHO Five Moments from recorded footage is not only possible but provides cost and time savings. In addition, the process may produce output that is less subject to the biases inherent in direct human observational auditing.
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5
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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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6
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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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Rapid development and implementation of a behaviour change strategy to improve COVID-19 personal protective equipment use in a regional Australian emergency department. Australas Emerg Care 2022; 25:273-282. [PMID: 35123929 PMCID: PMC8802564 DOI: 10.1016/j.auec.2022.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/20/2021] [Accepted: 01/23/2022] [Indexed: 01/09/2023]
Abstract
Objective To identify barriers to, describe the development of and evaluate the implementation of a behavioural theory informed strategy to improve staff personal protective equipment (PPE) compliance during COVID-19 in a regional Australian Emergency Department. Methods Barriers to PPE use were identified through staff consultation then categorised using the Theoretical Domains Framework. The Behaviour Change Wheel was used to develop a strategy to address the barriers to PPE compliance. The strategy was refined and endorsed by the site COVID taskforce. Data were collected through direct observation. Descriptive statistics were used to summarise PPE compliance and inductive content analysis for free text data of staff behaviours. Results 73 barriers were identified, mapped to 9 intervention functions and 42 behaviour change techniques. The predominant mechanisms were: (1) Executive communication reinforcing policy and consequences; (2) implementation of a PPE Marshal; (3) face to face reinforcement / modeling; (4) environmental restructuring including electronic medical record modifications. The PPE Marshal observed 281 PPE activities. PPE compliance varied between 47.9% (Buddy check) and 91.8% (Bare below elbow). The PPE Marshal intervened on 121 occasions, predominantly through buddying, explaining and demonstrating correct PPE use, most frequently with medical staff (72%). Conclusion We describe an evidence-based process to overcome barriers to PPE compliance that maximize safe work practice in a time critical situation. Staff require enabling, access to equipment and reinforcement to use PPE correctly.
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Borg S. Video-based observation in impact evaluation. EVALUATION AND PROGRAM PLANNING 2021; 89:102007. [PMID: 34547597 DOI: 10.1016/j.evalprogplan.2021.102007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
This paper reviews the literature on the use of video-based observation (VBO) with particular attention to monitoring and evaluation (M&E) on development projects. While the use of video both as a research tool and as a strategy for supporting professional development is well-documented across several disciplines, the extent to which VBO has been utilized in M&E contexts is less clearly defined. In order to provide theoretically-grounded recommendations for the development and implementation of one organisation's innovative VBO impact evaluation scheme, this review examines recent evidence of VBO in M&E contexts and draws on VBO literature more generally to identify its advantages and challenges together with advice for enhancing its effectiveness. Based on this analysis, the paper highlights a number of practical issues that should be considered when VBO is being developed for M&E in development contexts, particularly where videos are being made by participants themselves. The value of VBO in responding to COVID-19 and reducing carbon emissions is also noted.
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Affiliation(s)
- Simon Borg
- Department of Language, Literature, Mathematics and Interpretation, Western Norway University of Applied Sciences, Bergen, Norway.
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9
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Methodological and technical considerations for video-based auditing of hand hygiene compliance in clinical practice: an exploratory study. Am J Infect Control 2021; 49:1384-1391. [PMID: 33940065 DOI: 10.1016/j.ajic.2021.04.081] [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: 02/25/2021] [Revised: 04/23/2021] [Accepted: 04/23/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Direct observation is the gold standard method for measuring hand hygiene compliance but its utility is increasingly being questioned. Various alternative electronic methods have been proposed, yet there is a paucity of research examining the use of these according to the World Health Organization's (WHO) '5 Moments for Hand Hygiene'. As a part of the process of developing a video-based monitoring system (VMS) capable of measuring hand hygiene compliance against the 5 moments criteria this paper reports methodological and technical issues that might arise from the use of a VMS for auditing in clinical practice. METHODS In-depth semi-structured interviews were conducted with 27 Australian content experts in hand hygiene auditing and infection prevention to explore their responses to proposed VMS auditing approaches. Transcripts were analyzed using thematic and content analysis. RESULTS Technical and methodological considerations for the use of VMS were interrelated and included concerns surrounding privacy, footage security, fears of surveillance and the potential for medico-legal consequences. Additionally, possible detrimental impacts on healthcare worker (HCW) -patient relationships, issues of cost versus benefits, HCW and patient safety and changes to feedback were also identified. CONCLUSIONS The primary methodological and technical issues to overcome in order to implement VMS for hand hygiene auditing in clinical practice, centered upon issues of acceptability to patients and health professionals, privacy, consent and liability. CHECKLIST COREQ.
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10
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KHosravi N, Alami A, Aelami MH, KHosrovan S. Improving Hand Hygiene Compliance of Intensive Care Unit by Using Pender's Model. Ethiop J Health Sci 2021; 31:553-560. [PMID: 34483612 PMCID: PMC8365475 DOI: 10.4314/ejhs.v31i3.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022] Open
Abstract
Background Hand hygiene (HH) compliance is an effective behavior in controlling hospital-acquired infection because the hand is the main means of transmitting infections in patient-medical staff communication as well as the inanimate environment. This study aimed to explore the effect of applying Pender's Health Promotion Model on the HH compliance of intensive care unit staff. Methods This quasi-experimental study with a single research group was conducted from January to July in 2019. The required data were collected from 90 staff of the intensive care units of Imam Reza Hospital in Mashhad, Iran through 1796 and 2343 opportunity of monitoring before and after the intervention. The data collection instruments were a standard HH observation form and a researcher-made HH questionnaire in the light of Pender's health promotion model. The data were statistically analyzed in SPSS using Paired-samples T-test and Chi-squared test. Results The mean age of the 90 included participants was 35.92 (± 6.5) years and the mean length of their work experience was 10 (±1.5). The hand hygiene index rose from 23% before the intervention to 41.4% after the intervention (p=0.001). Moreover, statistically significant differences were found in moments after touching surroundings (p=0.001), before and after touching a patient (p=0.001), and also in perceived barriers (p=0.015), interpersonal influences (p=0.008) and situational influences (p<0.001). Conclusion Pender's model showed to have improved the staff's HH compliance as a professional behavior.
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Affiliation(s)
- Nasrin KHosravi
- Department of Community Health Nursing & Management Nursing, School of Nursing, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Ali Alami
- Department of Social Medicine, Social Determinants of Health Research Center, School of Public Health Faculty, Gonabad University of Medical Sciences, Gonabad, Iran. Orcid ID: https://orcid.org/0000-0002-8882-3110
| | - Mohammad Hasan Aelami
- Department of Pediatrics, School of Medicine, Antimicrobial Resistance Research Center, Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shahla KHosrovan
- Department of Community Health Nursing & Management Nursing, School of Nursing, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad
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Abstract
PURPOSE OF REVIEW Healthcare-associated infections (HAIs) challenge healthcare systems worldwide. As healthcare workers' hands are considered the main vector for transmission of pathogens, effective hand hygiene is the single most important action to prevent HAIs. We sought to highlight new developments and advances in hand hygiene. RECENT FINDINGS Hand hygiene compliance averages at 38%. A sustained increase of compliance with a subsequent decrease of HAIs may be achieved by national, systematic and rigorous education, and auditing programs. Periodically deployed self-operating hand hygiene surveillance systems coupled with personalized reminders could facilitate such efforts. Alcohol-based hand-rub (ABHR) solutions remain the hand hygiene gold standard, but are modified in texture and composition to better meet healthcare workers' preferences. Modifications of the hand hygiene procedure have been proposed targeting both time and technique of hand rub application. Reducing rub-time from 30 to 15 s and simplifying the technique to consist of three rather than six steps yielded encouraging results in terms of microbiological efficacy and higher compliance. SUMMARY Implementation and promotion of compliance are the major concerns of today's research on hand hygiene. Developments towards better surveillance and systematic education, improved ABHR formulation and streamlining of hand hygiene actions are paving the way ahead.
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Zhong X, Wang DL, Xiao LH, Mo LF, Wu QF, Chen YW, Luo XF. Comparison of two electronic hand hygiene monitoring systems in promoting hand hygiene of healthcare workers in the intensive care unit. BMC Infect Dis 2021; 21:50. [PMID: 33430792 PMCID: PMC7802277 DOI: 10.1186/s12879-020-05748-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 12/27/2020] [Indexed: 12/23/2022] Open
Abstract
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.
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Affiliation(s)
- Xiao Zhong
- Department of Nosocomial Infection Control, Shenzhen Hospital, University of Chinese Academy of Sciences, Shenzhen, 518106, Guangdong, China.
| | - Dong-Li Wang
- Inspection center, Guangming District Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Li-Hua Xiao
- Department of Nosocomial Infection Control, Shenzhen Hospital, University of Chinese Academy of Sciences, Shenzhen, 518106, Guangdong, China
| | - Lan-Fang Mo
- Department of Nosocomial Infection Control, Shenzhen Hospital, University of Chinese Academy of Sciences, Shenzhen, 518106, Guangdong, China
| | - Qing-Fei Wu
- Department of Nosocomial Infection Control, Shenzhen Hospital, University of Chinese Academy of Sciences, Shenzhen, 518106, Guangdong, China
| | - Yan-Wei Chen
- Department of Nosocomial Infection Control, Shenzhen Hospital, University of Chinese Academy of Sciences, Shenzhen, 518106, Guangdong, China
| | - Xiao-Feng Luo
- Department of Nosocomial Infection Control, Shenzhen Hospital, University of Chinese Academy of Sciences, Shenzhen, 518106, Guangdong, China
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13
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Xu N, Liu C, Feng Y, Li F, Meng X, Lv Q, Lan C. Influence of the Internet of Things management system on hand hygiene compliance in an emergency intensive care unit. J Hosp Infect 2020; 109:101-106. [PMID: 33346043 DOI: 10.1016/j.jhin.2020.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 12/01/2020] [Accepted: 12/10/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hand hygiene is a critical strategy for infection prevention in all healthcare settings. Automated electronic monitoring systems are expected to improve hand hygiene performance. AIM To investigate the impact of the Internet of Things (IoT) management system on hand hygiene compliance among medical staff in an emergency intensive care unit (EICU). METHODS This retrospective observational study was conducted between July 1st, 2017 and February 28th, 2018 in a 19-bed EICU. The changes in hand hygiene compliance among 54 members of medical staff and the incidence of hospital infections were compared, counted, and analysed before and after implementing the IoT management system in the EICU that was initiated on November 1st, 2017. FINDINGS After the application of the IoT management system, the hand hygiene compliance rates among the members of the medical staff before (29.5% (3347/11,338) vs 57.9% (4690/8094), P < 0.001) and after (59.9% (9915/16,556) vs 73.8% (17,194/23 286), P < 0.001) the contact with patients and surrounding environment significantly improved. However, hand hygiene compliance among three cleaning staff did not significantly improve after the application. Moreover, there was no significant difference in healthcare-acquired infection rates (2.535% (9/355) vs 2.047% (7/342), P = 0.667) nor in the detection rates of the four major multidrug-resistant bacteria in the EICU before and after the application of the IoT management system (P > 0.05). CONCLUSION The IoT management system significantly improved hand hygiene compliance among medical staff, except cleaners, in the EICU of one provincial hospital; however, the rates of nosocomial infection did not significantly decrease. The quality of hand hygiene implementation needs to be improved.
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Affiliation(s)
- N Xu
- Emergency Intensive Care Unit, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, PR China
| | - C Liu
- Department of Infection Management, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, PR China
| | - Y Feng
- Department of Infection Management, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, PR China
| | - F Li
- Department of Infection Management, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, PR China
| | - X Meng
- Emergency Intensive Care Unit, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, PR China
| | - Q Lv
- Emergency Intensive Care Unit, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, PR China
| | - C Lan
- Emergency Intensive Care Unit, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, PR China.
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