Automated Measures of Hand Hygiene Compliance among Healthcare Workers Using Ultrasound: Validation and a Randomized Controlled Trial

2013 ◽  
Vol 34 (9) ◽  
pp. 919-928 ◽  
Author(s):  
Dale A. Fisher ◽  
Theresa Seetoh ◽  
Helen Oh May-Lin ◽  
Sivakumar Viswanathan ◽  
Yanling Toh ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Control Method ◽  
Controlled Trial ◽  
Teaching Hospitals ◽  
Health Staff ◽  
Ultrasound Monitoring ◽  
Individual Feedback ◽  
Hygiene Compliance ◽  
The Impact

Objective.The primary objective of this study was to validate a novel method of assessing hand hygiene compliance using ultrasound transmitters in patient zones and staff tagged with receivers. The secondary objective was to assess the impact of audio reminders and quantified individual feedback.Design.An observational comparison against manual assessment followed by assessment using an open-label randomized control method.Setting.Patient zones were established in 3 wards of 2 large teaching hospitals, including 88 general and 18 intensive care unit ward beds.Participants.Consented regular ward nursing, medical, and allied health staff.Methods.Concordance between 40 hours of manual observation using trained hand hygiene auditors and automated measures of opportunities and compliance. Subsequent measured interventions were reminder beeps and written individual feedback.Results.When compared with manual observations, ultrasound monitoring underestimated percentage compliances by a nonsignificant mean (95% confidence interval [CI]) difference of 5.2% (−20.1% to 9.8%; P = .491). After the intervention, adjusted multivariate analysis showed mean (95% CI) overall compliance in the intervention arm was 6.8% (2.5%−11.1%; P = .002) higher than in the control arm. Results stratified by compliance at entry and exit showed that the effect of intervention was stronger for compliance at exit than at entry.Conclusions.Our automated measure of hand hygiene compliance is valid when compared with the traditional gold standard of manual observations. As an interventional tool, ultrasound-based automated hand hygiene audits have significant benefit that can be built upon with enhancements and find increasing acceptance with time.

scholarly journals Improving Hand Hygiene Compliance in Nursing Homes: Protocol for a Cluster Randomized Controlled Trial (HANDSOME Study)

10.2196/17419 ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. e17419 ◽  
Author(s):  
Gwen R Teesing ◽  
Vicki Erasmus ◽  
Mariska Petrignani ◽  
Marion P G Koopmans ◽  
Miranda de Graaf ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Nursing Homes ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Disease Incidence ◽  
Controlled Trial ◽  
World Health ◽  
The World ◽  
Hygiene Compliance ◽  
Cluster Randomized

Background Hand hygiene compliance is considered the most (cost-)effective measure for preventing health care–associated infections. While hand hygiene interventions have frequently been implemented and assessed in hospitals, there is limited knowledge about hand hygiene compliance in other health care settings and which interventions and implementation methods are effective. Objective This study aims to evaluate the effect of a multimodal intervention to increase hand hygiene compliance of nurses in nursing homes through a cluster randomized controlled trial (HANDSOME study). Methods Nursing homes were randomly allocated to 1 of 3 trial arms: receiving the intervention at a predetermined date, receiving the identical intervention after an infectious disease outbreak, or serving as a control arm. Hand hygiene was evaluated in nursing homes by direct observation at 4 timepoints. We documented compliance with the World Health Organization’s 5 moments of hand hygiene, specifically before touching a patient, before a clean/aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings. The primary outcome is hand hygiene compliance of the nurses to the standards of the World Health Organization. The secondary outcome is infectious disease incidence among residents. Infectious disease incidence was documented by a staff member at each nursing home unit. Outcomes will be compared with the presence of norovirus, rhinovirus, and Escherichia coli on surfaces in the nursing homes, as measured using quantitative polymerase chain reaction. Results The study was funded in September 2015. Data collection started in October 2016 and was completed in October 2017. Data analysis will be completed in 2020. Conclusions HANDSOME studies the effectiveness of a hand hygiene intervention specifically for the nursing home environment. Nurses were taught the World Health Organization’s 5 moments of hand hygiene guidelines using the slogan “Room In, Room Out, Before Clean, After Dirty,” which was developed for nursing staff to better understand and remember the hygiene guidelines. HANDSOME should contribute to improved hand hygiene practice and a reduction in infectious disease rates and related mortality. Trial Registration Netherlands Trial Register (NTR6188) NL6049; https://www.trialregister.nl/trial/6049 International Registered Report Identifier (IRRID) DERR1-10.2196/17419

Variability in the Hawthorne Effect With Regard to Hand Hygiene Performance in High- and Low-Performing Inpatient Care Units

2009 ◽  
Vol 30 (3) ◽  
pp. 222-225 ◽  
Author(s):  
Erol Kohli ◽  
Judy Ptak ◽  
Randall Smith ◽  
Eileen Taylor ◽  
Elizabeth A. Talbot ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Inpatient Care ◽  
Hand Hygiene Compliance ◽  
Hospital Staff ◽  
High Rate ◽  
Hawthorne Effect ◽  
High Performing ◽  
Hygiene Compliance ◽  
The Impact ◽  
Student Intern

Objective.To determine the impact of known observers on hand hygiene performance in inpatient care units with differing baseline levels of hand hygiene compliance.Design.Observational study.Setting.Three inpatient care units, selected on the basis of past hand hygiene performance, in a hospital where hand hygiene observation and feedback are routine.Participants.Three infection control practitioners (ICPs) and a student intern observed hospital staff.Methods.Beginning in late 2005, the 3 ICPs, who were well known to the hospital staff, performed frequent, regular observations of hand hygiene in all 3 inpatient care units of the hospital, as part of routine surveillance. During the study period (January-May 2007), a student intern who was unknown to the hospital staff also performed observations of hand hygiene in the 3 inpatient care units. The rates of hand hygiene compliance observed by the 3 ICPs were compared with those observed by the student intern.Results.The 3 ICPs observed 332 opportunities for hand hygiene during 15 observation periods, and the student intern observed 355 opportunities during 19 observation periods. The overall rate of hand hygiene compliance observed by the ICPs was 65% (ie, in 215 of the 332 opportunities, the performance of proper hand hygiene by hospital staff was observed), and the overall rate of hand hygiene compliance observed by the student intern was 58% (ie, in 207 of the 355 opportunities, the performance of proper hand hygiene by hospital staff was observed) (P = .1). Both the ICPs and the student intern were able to distinguish between inpatient care units with a high rate of hand hygiene compliance (hereafter referred to as high-performing units) and those with a low rate (hereafter referred to as low-performing units). However, in the 2 high-performing units, the ICPs observed significantly higher compliance rates than did the student intern, whereas in the low-performing unit, both the ICPs and the student intern measured similarly low rates of hand hygiene compliance.Conclusions.Recognized observers are associated with higher rates of hand hygiene compliance, even in a healthcare setting where such observations have become routine. This effect (ie, the Hawthorne effect) is more pronounced in high-performing units and insignificant in low-performing units. The use of unrecognized observers may be important for verifying high performance but is probably unnecessary for documenting poor performance. Moreover, the Hawthorne effect may be a useful tool for sustaining and improving hand hygiene compliance.

scholarly journals Impact of Infection Control Training Program in Improving the Quality of Healthcare

2020 ◽  
Vol 2 (5) ◽  
Author(s):  
Aeshah N. Alqahtani ◽  
Rana H. Almaghrabi ◽  
Mohammed M. Albaadani ◽  
Khalid Almossa
Keyword(s):  
Hand Hygiene ◽  
Training Program ◽  
Hand Hygiene Compliance ◽  
Training Programs ◽  
Financial Burden ◽  
Quality Of Healthcare ◽  
Healthcare Associated Infection ◽  
Hygiene Compliance ◽  
The Impact

The purpose of this study was to explore the impact of various training programs and guidelines on improving the healthcare quality and patient. The training programs that we have explained in this study are related to Hand Hygiene compliance, Improving clinical outcomes and reducing financial burden and Preventing healthcare associated infection, This study Applied to many health institutions and healthcare employees in the Kingdom of Saudi Arabia, It is from this analysis that improve quality of healthcare through control training program, IPC training program improve hand hygiene compliance and reduces the HAIs prevalence, improves patient outcomes and reduces healthcare costs, training of all the persons involved in primary healthcare may fill the IPC gaps.

scholarly journals Increased hand hygiene compliance in nursing homes after a multimodal intervention: A cluster randomized controlled trial (HANDSOME)

2020 ◽  
Vol 41 (10) ◽  
pp. 1169-1177
Author(s):  
Gwen R. Teesing ◽  
Vicki Erasmus ◽  
Daan Nieboer ◽  
Mariska Petrignani ◽  
Marion P.G Koopmans ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Nursing Homes ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Controlled Trial ◽  
Multimodal Intervention ◽  
Randomized Controlled ◽  
Hygiene Compliance ◽  
Cluster Randomized

AbstractObjective:To assess the effect of a multimodal intervention on hand hygiene compliance (HHC) in nursing homes.Design, setting, and participants:HHC was evaluated using direct, unobtrusive observation in a cluster randomized controlled trial at publicly funded nursing homes in the Netherlands. In total, 103 nursing home organizations were invited to participate; 18 organizations comprising 33 nursing homes (n = 66 nursing home units) participated in the study. Nursing homes were randomized into a control group (no intervention, n = 30) or an intervention group (multimodal intervention, n = 36). The primary outcome measure was HHC of nurses. HHC was appraised at baseline and at 4, 7, and 12 months after baseline. Observers and nurses were blinded.Intervention:Audits regarding hand hygiene (HH) materials and personal hygiene rules, 3 live lessons, an e-learning program, posters, and a photo contest. We used a new method to teach the nurses the WHO-defined 5 moments of HH: Room In, Room Out, Before Clean, and After Dirty.Results:HHC increased in both arms. The increase after 12 months was larger for units in the intervention arm (from 12% to 36%) than for control units (from 13% to 21%) (odds ratio [OR], 2.10; confidence interval [CI], 1.35–3.28). The intervention arm exhibited a statistically significant increase in HHC at 4 of the 5 WHO-defined HH moments. At follow-up, HHC in the intervention arm remained statistically significantly higher (OR, 1.93; 95% CI, 1.59–2.34) for indications after an activity (from 37% to 39%) than for indications before an activity (from 14% to 27%).Conclusions:The HANDSOME intervention is successful in improving HHC in nursing homes.

Establishing Evidence-Based Criteria for Directly Observed Hand Hygiene Compliance Monitoring Programs: A Prospective, Multicenter Cohort Study

2014 ◽  
Vol 35 (9) ◽  
pp. 1163-1168 ◽  
Author(s):  
Jun Yin ◽  
Heather Schacht Reisinger ◽  
Mark Vander Weg ◽  
Marin L. Schweizer ◽  
Andrew Jesson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Sample Size Calculation ◽  
Hawthorne Effect ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
Surveillance Programs ◽  
Hygiene Compliance ◽  
The Impact

ObjectiveHand hygiene surveillance programs that rely on direct observations of healthcare worker activity may be limited by the Hawthorne effect. In addition, comparing compliance rates from period to period requires adequately sized samples of observations. We aimed to statistically determine whether the Hawthorne effect is stable over an observation period and statistically derive sample sizes of observations necessary to compare compliance rates.DesignProspective multicenter cohort study.SettingFive intensive care units and 6 medical/surgical wards in 3 geographically distinct acute care hospitals.MethodsTrained observers monitored hand hygiene compliance during routine care in fixed 1-hour periods, using a standardized collection tool. We estimated the impact of the Hawthorne effect using empirical fluctuation processes and F tests for structural change. Standard sample-size calculation methods were used to estimate how many hand hygiene opportunities are required to accurately measure hand hygiene across various levels of baseline and target compliance.ResultsExit hand hygiene compliance increased after 14 minutes of observation (from 56.2% to 60.5%; P < .001) and increased further after 50 minutes (from 60.5% to 66.0%; P < .001). Entry compliance increased after 38 minutes (from 40.4% to 43.4%; P = .005). Between 79 and 723 opportunities are required during each period, depending on baseline compliance rates (range, 35%–90%) and targeted improvement (5% or 10%).ConclusionsLimiting direct observation periods to approximately 15 minutes to minimize the Hawthorne effect and determining required number of hand hygiene opportunities observed per period on the basis of statistical power calculations would be expected to improve the validity of hand hygiene surveillance programs.Infect Control Hosp Epidemiol 2014;35(9):1163-1168

scholarly journals Improvement in hand hygiene compliance. The impact of a regional strategy

2011 ◽  
Vol 5 (S6) ◽  
Author(s):  
P Rodriguez-Perez ◽  
CC Mireia ◽  
RR Cristina ◽  
PM Rosa ◽  
JM Ana Belén ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Regional Strategy ◽  
Hygiene Compliance ◽  
The Impact

scholarly journals Evaluating the Impact of a Unit-Driven Awareness Campaign on Hand Hygiene Compliance

2012 ◽  
Vol 16 ◽  
pp. e379-e380
Author(s):  
S.F. Mahmood ◽  
S. Musani ◽  
H. Amin ◽  
R. Khowaja ◽  
S. Jindani ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Awareness Campaign ◽  
Hygiene Compliance ◽  
The Impact
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