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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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Granqvist K, Ahlstrom L, Karlsson J, Lytsy B, Erichsen A. Central aspects when implementing an electronic monitoring system for assessing hand hygiene in clinical settings: A grounded theory study. J Infect Prev 2024; 25:51-58. [PMID: 38584715 PMCID: PMC10998548 DOI: 10.1177/17571774241230678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/21/2024] [Indexed: 04/09/2024] Open
Abstract
Background New technologies, such as electronic monitoring systems, have been developed to promote increased adherence to hand hygiene among healthcare workers. However, challenges when implementing these technologies in clinical settings have been identified. Aim The aim of this study was to explore healthcare workers' experiences when implementing an electronic monitoring system to assess hand hygiene in a clinical setting. Method Interviews with healthcare workers (registered nurses, nurse assistants and leaders) involved in the implementation process of an electronic monitoring system (n = 17) were conducted and data were analyzed according to the grounded theory methodology formulated by Strauss and Corbin. Results Healthcare workers' experiences were expressed in terms of leading and facilitating, participating and contributing, and knowing and confirming. These three aspects were merged together to form the core category of collaborating for progress. Leaders were positive and committed to the implementation of the electronic monitoring system, endeavouring to enable facilitation and support for their co-workers (registered nurses and nurse assistants). At the same time, co-workers were positive about the support they received and contributed by raising questions and demands for the product to be used in clinical settings. Moreover, leaders and co-workers were aware of the objective of implementing the electronic monitoring system. Conclusion We identified dynamic collective work between leaders and co-workers during the implementation of the electronic monitoring system. Leadership, participation and knowledge were central aspects of enhancing a collaborative process. We strongly recommend involving both ward leaders and users of new technologies to promote successful implementation.
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Affiliation(s)
- Karin Granqvist
- Department of Anaesthesia, Surgery and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
- The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Linda Ahlstrom
- The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Birgitta Lytsy
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Sweden
| | - Annette Erichsen
- The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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Boyce JM. Current issues in hand hygiene. Am J Infect Control 2023; 51:A35-A43. [PMID: 37890952 DOI: 10.1016/j.ajic.2023.02.003] [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: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Multiple aspects of hand hygiene have changed in recent years. METHODS A PubMed search was conducted to identify recent articles about hand hygiene. RESULTS The COVID-19 pandemic caused temporary changes in hand hygiene compliance rates and shortages of alcohol-based hand sanitizers (ABHSs), and in marketing of some products that were ineffective or unsafe. Fortunately, ABHSs are effective against SARS-CoV-2 and other emerging pathogens including Candida auris and mpox. Proper placement, maintenance, and design of ABHS dispensers have gained additional attention. Current evidence suggests that if an adequate volume of ABHS has been applied to hands, personnel must rub their hands together for at least 15 seconds before hands feel dry (dry time), which is the primary driver of antimicrobial efficacy. Accordingly, practical methods of monitoring hand hygiene technique are needed. Direct observation of hand hygiene compliance remains a challenge in many healthcare facilities, generating increased interest in automated hand hygiene monitoring systems (AHHMSs). However, several barriers have hindered widespread adoption of AHHMSs. AHHMSs must be implemented as part of a multimodal improvement program to successfully improve hand hygiene performance rates. CONCLUSIONS Remaining gaps in our understanding of hand hygiene warrant continued research into factors impacting hand hygiene practices.
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Affiliation(s)
- John M Boyce
- J.M. Boyce Consulting, LLC, Middletown, CT, USA.
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Granqvist K, Ahlstrom L, Karlsson J, Lytsy B, Andersson AE. Learning to interact with new technology: Health care workers' experiences of using a monitoring system for assessing hand hygiene - a grounded theory study. Am J Infect Control 2022; 50:651-656. [PMID: 34610392 DOI: 10.1016/j.ajic.2021.09.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Recently, innovative technologies for hand hygiene (HH) monitoring have been developed to improve HH adherence in health care. This study explored health care workers' experiences of using an electronic monitoring system to assess HH adherence. METHODS An electronic monitoring system with digital feedback was installed on a surgical ward and interviews with health care workers using the system (n = 17) were conducted. The data were analyzed according to grounded theory by Strauss and Corbin. RESULTS Health care workers' experiences were expressed in terms of having trust in the monitoring system, requesting system functionality and ease of use and becoming aware of one's own performance. This resulted in the core category of learning to interact with new technology, summarized as the main strategy when using an electronic monitoring system in clinical settings. The system with digital feedback improved the awareness of HH and individual feedback was preferable to group feedback. CONCLUSIONS Being involved in using and managing a technical innovation for assessing HH adherence in health care is a process of formulating a strategy for learning to interact with new technology. The importance of inviting health care workers to participate in the co-design of technical innovations is crucial, as it creates both trust in the innovation per se and trust in the process of learning how to use it.
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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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Thibaut A, Olga FB, Fanyu H, Jeremy G, Jean G, Sophia B, Isabelle R, Céline PE, Michel D, Philippe B. Binding communication to improve peripheral venous catheter monitoring. J Eval Clin Pract 2022; 28:186-193. [PMID: 34346126 DOI: 10.1111/jep.13602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/08/2021] [Accepted: 07/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Optimizing the monitoring of peripheral venous catheters is essential. We developed a nursing record system at bedside (Patient Smart Reader) to track peripheral venous catheter acts. AIMS The aim of the present study was to improve peripheral venous catheter monitoring. To improve the quality of monitoring, we aimed to increase the usage of the nursing record system at the bedside. METHODS We developed a 'commitment intervention' course based on a binding communication paradigm. The corresponding effect on monitoring was analysed using a p-chart and time series analysis. FINDINGS Nurses observed a significant improvement in compliance with catheter monitoring over time (shifts after shifts), ranging from 27.6% (CI = [25.3; 30.0]) compliance before the commitment intervention to 47.4% (CI = [45.0; 49.9]) compliance after training. The commitment intervention increased the chances of carrying out monitoring through the tool for acts related to peripheral venous catheters by a factor of 2.42 (odds ratio) (CI = [1.88; 3.11]). CONCLUSION Binding communication provides an effective method for changing nurses' behaviours in terms of safe care. The determinants of engagement (individual vs collective) can be indicators for defining future communication and training strategies in care centers for all health care workers.
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Affiliation(s)
- Albertini Thibaut
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France.,Mediterranean Institute for Information and Communication Science, Aix Marseille Univ, Marseille, France
| | - Florea Bodean Olga
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France
| | - Huang Fanyu
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France
| | - Gonin Jeremy
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France.,AP-HM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistics & ICT, Aix Marseille Univ, Marseille, France
| | - Gaudart Jean
- AP-HM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistics & ICT, Aix Marseille Univ, Marseille, France
| | - Boudjema Sophia
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France
| | - Richer Isabelle
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France
| | - Pascual-Espuny Céline
- Mediterranean Institute for Information and Communication Science, Aix Marseille Univ, Marseille, France
| | - Durampart Michel
- Mediterranean Institute for Information and Communication Science, Aix Marseille Univ, Marseille, France
| | - Brouqui Philippe
- AP-HM, IRD, IHU-Méditerranée Infection, MEPHI, Aix Marseille Univ, Marseille, France
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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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8
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Meng M, Seidlein AH, Kugler C. Hand hygiene monitoring technology: A descriptive study of ethics and acceptance in nursing. Nurs Ethics 2021; 29:436-447. [PMID: 34525855 DOI: 10.1177/09697330211015351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Nosocomial infections represent a serious challenge for healthcare systems worldwide. Adherence to hand hygiene plays a major role in infection prevention and control. These adherence rates can be improved through behaviour tracking innovations. This requires the systems to be widely implemented and accepted. Therefore, both a systematic analysis of the normative issues related and the evaluation of technology acceptance are equally important. OBJECTIVES To explore and describe relevant aspects regarding the acceptance of technology and ethical implications using a tracking device to measure and improve adherence to hand hygiene. RESEARCH DESIGN A quantitative study with a descriptive design was performed. PARTICIPANTS AND RESEARCH CONTEXT A total of 75 questionnaires were collected in three hospitals in Germany. Acceptance of technology was measured with n = 60 participants (n = 50 nurses; n = 9 physicians; n = 1 not disclosed) and ethical assessment with n = 15 participants (nurses only). ETHICAL CONSIDERATIONS Ethical approval for this study was obtained from the institutional review board. FINDINGS The acceptance of technologies improving hygiene in general was good (median = 80.5, interquartile range = 28, range: 0-100). The experience with technologies in general (median = 48.5, interquartile range = 57, range: 0-100) and the acceptance of the specific technology (mean = 82.23, standard deviation = 15.16 (range: 23-138)) was moderate. There was a significant positive correlation between the acceptance and experience of technology in general (r = 0.217, p = .025). Ethical concerns played a minor role. The need for practical support was a key topic. DISCUSSION Study participants accepted technologies improving hygiene; however, the specific device implemented was only moderately accepted. This creates specific opportunities in the implementation process for higher later acceptance. More practical support and an increase in experience may create opportunities for device implementation with high acceptance and low ethical concerns. CONCLUSION Study results indicate a vast potential for improving the implementation process of hand hygiene technologies. Ethical concerns in this study did not seem to be a relevant barrier for successful implementation of hand hygiene technologies.
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Affiliation(s)
- Michael Meng
- Albert-Ludwigs-University Freiburg, Germany; Federal Institute for Vocational Education and Training (BIBB), Germany
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9
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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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10
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Fournier PE, Edouard S, Wurtz N, Raclot J, Bechet M, Zandotti C, Filosa V, Raoult D, Fenollar F. Contagion Management at the Méditerranée Infection University Hospital Institute. J Clin Med 2021; 10:jcm10122627. [PMID: 34203657 PMCID: PMC8232197 DOI: 10.3390/jcm10122627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 12/21/2022] Open
Abstract
The Méditerranée Infection University Hospital Institute (IHU) is located in a recent building, which includes experts on a wide range of infectious disease. The IHU strategy is to develop innovative tools, including epidemiological monitoring, point-of-care laboratories, and the ability to mass screen the population. In this study, we review the strategy and guidelines proposed by the IHU and its application to the COVID-19 pandemic and summarise the various challenges it raises. Early diagnosis enables contagious patients to be isolated and treatment to be initiated at an early stage to reduce the microbial load and contagiousness. In the context of the COVID-19 pandemic, we had to deal with a shortage of personal protective equipment and reagents and a massive influx of patients. Between 27 January 2020 and 5 January 2021, 434,925 nasopharyngeal samples were tested for the presence of SARS-CoV-2. Of them, 12,055 patients with COVID-19 were followed up in our out-patient clinic, and 1888 patients were hospitalised in the Institute. By constantly adapting our strategy to the ongoing situation, the IHU has succeeded in expanding and upgrading its equipment and improving circuits and flows to better manage infected patients.
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Affiliation(s)
- Pierre-Edouard Fournier
- IHU-Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.-E.F.); (S.E.); (N.W.); (J.R.); (M.B.); (C.Z.); (V.F.); (D.R.)
- VITROME Unit, IRD, AP-HM, SSA, IHU-Méditerranée Infection, Aix Marseille University, 13005 Marseille, France
| | - Sophie Edouard
- IHU-Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.-E.F.); (S.E.); (N.W.); (J.R.); (M.B.); (C.Z.); (V.F.); (D.R.)
- MEPHI Unit, IRD, AP-HM, IHU Méditerranée Infection, Aix Marseille University, 13005 Marseille, France
| | - Nathalie Wurtz
- IHU-Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.-E.F.); (S.E.); (N.W.); (J.R.); (M.B.); (C.Z.); (V.F.); (D.R.)
- VITROME Unit, IRD, AP-HM, SSA, IHU-Méditerranée Infection, Aix Marseille University, 13005 Marseille, France
| | - Justine Raclot
- IHU-Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.-E.F.); (S.E.); (N.W.); (J.R.); (M.B.); (C.Z.); (V.F.); (D.R.)
| | - Marion Bechet
- IHU-Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.-E.F.); (S.E.); (N.W.); (J.R.); (M.B.); (C.Z.); (V.F.); (D.R.)
| | - Christine Zandotti
- IHU-Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.-E.F.); (S.E.); (N.W.); (J.R.); (M.B.); (C.Z.); (V.F.); (D.R.)
| | - Véronique Filosa
- IHU-Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.-E.F.); (S.E.); (N.W.); (J.R.); (M.B.); (C.Z.); (V.F.); (D.R.)
| | - Didier Raoult
- IHU-Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.-E.F.); (S.E.); (N.W.); (J.R.); (M.B.); (C.Z.); (V.F.); (D.R.)
- MEPHI Unit, IRD, AP-HM, IHU Méditerranée Infection, Aix Marseille University, 13005 Marseille, France
| | - Florence Fenollar
- IHU-Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.-E.F.); (S.E.); (N.W.); (J.R.); (M.B.); (C.Z.); (V.F.); (D.R.)
- VITROME Unit, IRD, AP-HM, SSA, IHU-Méditerranée Infection, Aix Marseille University, 13005 Marseille, France
- Correspondence: ; Tel.: + 33-(0)-4-13-73-24-01; Fax: +33-(0)-4-13-73-24-02
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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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Affiliation(s)
- K Prescott
- Healthcare Infection Society, Montagu House, Wakefield Street, London, WC1N, UK.
| | - N Mahida
- Healthcare Infection Society, Montagu House, Wakefield Street, London, WC1N, UK
| | - M Wilkinson
- Healthcare Infection Society, Montagu House, Wakefield Street, London, WC1N, UK
| | - J Gray
- Healthcare Infection Society, Montagu House, Wakefield Street, London, WC1N, UK
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13
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Healthcare workers' attitudes to how hand hygiene performance is currently monitored and assessed. J Hosp Infect 2020; 105:705-709. [DOI: 10.1016/j.jhin.2020.05.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/26/2020] [Indexed: 12/21/2022]
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