Identifying interventions to improve hand hygiene compliance in the intensive care unit through co-design with stakeholders

Hand Hygiene Messaging Design in the Workplace: Views From the Workforce-Introduction

AIMS

The study aimed to (1) discover workers' attitudes toward the use of novel video screens to improve hand sanitization in the workplace and (2) discover what workers' preferences are for hand hygiene (HH) messaging style and tone and reasons for their preferences.

BACKGROUND

Practicing good HH in non-medical office settings is vital to curb the spread of a range of common and infectious diseases. Despite this, workers are rarely consulting in the construction of HH messages. The qualitative views of users can provide us with the "why" rather than the "what" and can highlight areas of cynicism, concern and overall attitudes to HH.

METHODS

A survey was completed by 520 UK workers concerning attitudes and views toward HH messaging and the use of a video-based hand sanitizer unit. Analysis consisted of both qualitative and quantitative methods.

RESULTS

Workers were skeptical toward the use of digital technologies within HH interventions, and there were misgivings about the role that video could play. Results demonstrated a strong preference for positive and supportive messages. Educational and trustworthy qualities were well rated. Messages that emphasized surveillance, previously successful in a clinical setting, or guilt, were not well received. Visual approaches that utilized serious illustration were valued.

CONCLUSION

This study highlights how consulting workers before the design of HH initiatives is important in guiding the design process. The resultant user-centered criteria promotes the use of positive, motivational, thought-provoking, surprising, and visual approaches to HH messaging.

Action research on promoting hand hygiene practices in an intensive care unit

AIM

Evaluate the intensive care acquired infections incidence and the change over time in infection practices in one intensive care unit.

DESIGN

We used an action research approach with cyclical activities.

METHODS

Our study included two cycles with hand hygiene observation based on the WHO's five-moments observation tool, observing hand hygiene practices, analysing the observations, and giving feedback on observations, intensive care acquired infection rates, and alcohol-based hand rub consumption. The Revised Standards for Quality Improvement Reporting Excellence is the basis for this research report describing research aimed at improving patient safety and quality of care.

RESULTS

During the study, annual alcohol-based hand rub consumption increased by 6.7 litres per 1000 patient days and observed hand hygiene compliance improved. In the first cycle of the study, there was a decrease in critical care acquired infection rates, but the improvement was not sustainable.