scholarly journals Evaluating the effect of electronic monitoring and feedback on hand cream use in healthcare workers: Healthy Hands Project

2018 ◽  
Vol 80 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Maryam Soltanipoor ◽  
Thomas Rustemeyer ◽  
Judith K. Sluiter ◽  
John Hines ◽  
Federico Frison ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Electronic Monitoring ◽  
Hand Cream

Measuring Healthcare Worker Hand Hygiene Activity: Current Practices and Emerging Technologies

2011 ◽  
Vol 32 (10) ◽  
pp. 1016-1028 ◽  
Author(s):  
John M. Boyce
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Electronic Monitoring ◽  
Monitoring Systems ◽  
Improve Hand Hygiene ◽  
Hand Hygiene Improvement ◽  
Gold Standard Method ◽  
Improvement Programs ◽  
Hygiene Compliance

Monitoring hand hygiene compliance and providing healthcare workers with feedback regarding their performance are considered integral parts of multidisciplinary hand hygiene improvement programs. Observational surveys conducted by trained personnel are currently considered the “gold standard” method for establishing compliance rates, but they are time-consuming and have a number of shortcomings. Monitoring hand hygiene product consumption is less time-consuming and can provide useful information regarding the frequency of hand hygiene that can be used to give caregivers feedback. Electronic counting devices placed in hand hygiene product dispensers provide detailed information about hand hygiene frequency over time, by unit and during interventions. Electronic hand hygiene monitoring systems that utilize wireless systems to monitor room entry and exit of healthcare workers and their use of hand hygiene product dispensers can provide individual and unit-based data on compliance with the most common hand hygiene indications. Some systems include badges (tags) that can provide healthcare workers with real-time reminders to clean their hands upon entering and exiting patient rooms. Preliminary studies suggest that use of electronic monitoring systems is associated with increased hand hygiene compliance rates and that such systems may be acceptable to care givers. Although there are many questions remaining about the practicality, accuracy, cost, and long-term impact of electronic monitoring systems on compliance rates, they appear to have considerable promise for improving our efforts to monitor and improve hand hygiene practices among healthcare workers.

scholarly journals Observational Bias Within Hospital-Wide Hand Hygiene Program

2020 ◽  
Vol 41 (S1) ◽  
pp. s333-s333
Author(s):  
Amy Marques ◽  
Robert Tucker ◽  
Michael Klompas
Keyword(s):  
Data Collection ◽  
Hand Hygiene ◽  
Patient Care ◽  
Healthcare Workers ◽  
Electronic Monitoring ◽  
Peer Group ◽  
Group Versus ◽  
Professional Group ◽  
Care Hospital ◽  
Peer Observations

Background: Hand hygiene (HH) is critical to prevent hospital-acquired infections. Running a successful HH program requires valid and accurate HH data to monitor the status and progress of HH improvement efforts. HH data are frequently subject to variable forms of bias, for which considerations must be made to enhance the validity of HH data. Objective: We assessed the extent to which observers may be prone to report more favorable HH rates when observing healthcare workers from the same professional group versus members of other job categories. Methods: We analyzed HH data from 48,543 electronically collected observations conducted by frontline healthcare workers in a 793-bed acute-care hospital from January 1, 2019, through July 31, 2019. All auditors received training on HH observations and proper use of the data collection application. Compliance data were sorted into peer versus nonpeer observations by profession. We compared HH compliance rates for members of each professional group when monitoring peers versus nonpeers. We further stratified results by ancillary professions (central transport, unit associates, food services, pharmacy, phlebotomy, rehabilitation services, and respiratory therapy) versus nonancillary professions (doctors, nurses, physician assistants, patient care assistants). Results: Of 12,488 ancillary observations, 7,184 (57.5%) were peer observations and 36,055 were nonancillary observations, of which 15,942 (44.2%) were peer observations. The percentage of peer-to-peer observations versus nonpeer observations varied by profession, ranging from 96% of central transport workers and 91% of environmental services observations to 21% of patient care assistants and 34% of physician’s assistants. Average compliance rates for peer versus nonpeer observations in ancillary groups were 98% (95% CI, 98.7%–99.2%) versus 83% (95% CI, 82.5%–84.5%). Average compliance rates nonancillary groups were 92% (95% CI, 92.0%–92.8%) for peers versus 88% (95% CI, 87.8%–88.7%) for nonpeers (Table 1). Conclusions: We documented a propensity for some categories of healthcare workers to record discrepant rates of HH compliance when observing members of the same peer group versus others. This effect was more pronounced amongst ancillary versus nonancillary services. This study adds to the literature of potential sources of bias in HH monitoring programs. Operational changes in HH program data collection may be warranted to try to mitigate these biases such as increasing the frequency of validation exercises conducted by nonaffiliated observers, weighting peer versus nonpeer observations differently, or switching to automated electronic monitoring systems.Funding: NoneDisclosures: None

scholarly journals Electronic Monitoring of Individual Healthcare Workers’ Hand Hygiene Event Rate

2014 ◽  
Vol 35 (9) ◽  
pp. 1189-1192 ◽  
Author(s):  
Matthew P. Muller ◽  
Alexander I. Levchenko ◽  
Stanley Ing ◽  
Steven M. Pong ◽  
Geoff R. Fernie
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Electronic Monitoring ◽  
Event Rate ◽  
Individual Healthcare

scholarly journals O5B.5 Effectiveness of a skin care program for the prevention of occupational contact dermatitis in healthcare workers

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A44.2-A45
Author(s):  
Henk van der Molen ◽  
Sanja Kezic ◽  
Maryam Soltanipoor ◽  
Thomas Rustemeyer
Keyword(s):  
Healthcare Workers ◽  
Electronic Monitoring ◽  
Intervention Group ◽  
Hand Eczema ◽  
Skin Care ◽  
Control Group ◽  
Wet Work ◽  
Hand Dermatitis ◽  
Occupational Contact Dermatitis ◽  
Positive Effects

Healthcare workers (HCW) are at risk for developing hand dermatitis (HD) caused by exposure to wet work. Guidelines for the prevention of HD recommend regular use of moisturizers, however in practice their use remains low and their effectiveness is poorly investigated.The main objective of this randomized control trial was to assess whether an intervention aimed at improving skin care leads to reduction in HD severity. The intervention included provision of cream dispensers with electronic monitoring of use, regularly communicated to the HCW. The primary and secondary outcomes were change from baseline in Hand Eczema Severity Index score (ΔHECSI) and Natural Moisturizing Factor (ΔNMF) levels as a biomarker of early changes in the skin barrier. Nine wards (285 HCW) were allocated to an intervention group (IG) and 10 wards (216 HCW) to the control group (CG).At baseline, IG and CG had similar exposure to wet work, use of skin care and severity of HD. At follow-up (1 year) the IG showed significantly higher frequency of hand cream use as compared to the CG (self-reported data). Though, electronically collected data in the IG showed that the average frequency of 0.4 cream applications/shift was far below recommended 2 applications/shift. The HECSI reduced significantly in the IG for −6.2 (95%CI −7.7,−4.7) and in the CG −4.2 points (95% CI −6.0,–2.4). There was no difference in ΔHECSI or ΔNMF between IG and CG, however the subgroup showing mild symptoms showed significantly larger improvement in HD symptoms as compared with CG.The intervention proved overall positive effects on severity of HD symptoms, supporting the benefits of skin care in the workplace. The fact that the intervention showed a larger effect in a subgroup with mild symptoms suggests that this intervention might be of particular importance for primary prevention.

scholarly journals Large-Scale Analysis of Hand Hygiene Frequency Across Healthcare Facilities Varying in Key Hospital Characteristics

2020 ◽  
Vol 41 (S1) ◽  
pp. s448-s448
Author(s):  
Jessica Albright ◽  
Bruce White ◽  
Pete Carlson ◽  
Cheryl Littau
Keyword(s):  
Hand Hygiene ◽  
Healthcare Worker ◽  
Monitoring System ◽  
Healthcare Workers ◽  
Electronic Monitoring ◽  
Small Sample ◽  
Healthcare Facilities ◽  
Hygiene Practices ◽  
Area Classification ◽  
Hospital Characteristics

Background: Hand hygiene by healthcare personnel is a critical infection prevention intervention. Direct observation, the most widely utilized method to observe hand hygiene practices, often provides an incomplete picture due to small sample size and altered behavior in the presence of observers. A growing number of healthcare facilities are employing electronic hand hygiene monitoring systems to capture overall compliance rates. These electronic systems can provide a wealth of data on hand hygiene practices within and across healthcare facilities. Objective: We used high-accuracy electronic monitoring data to perform a detailed analysis of hand hygiene practices across numerous facilities that varied in key hospital characteristics. Methods: In total, 11 tertiary-care facilities were equipped with an electronic hand hygiene monitoring system. Hospitals varied in size, region, area classification (urban vs rural), acuity level, and teaching status. The electronic monitoring system was composed of uniquely assigned employee badges and electronically monitored dispensers. Every recorded dispensing event was time stamped and associated with a specific healthcare worker, the location of the dispenser, and the specific product being dispensed (ie, alcohol-based hand rub [ABHR] or hand soap). The total number of dispensing events for each product type and the total number of hours worked were calculated for each healthcare worker and were used to determine hand hygiene frequency. Hospital attributes, such as size and area classification, were obtained from publicly available sources including but not limited to facility-owned websites and CMS data. Results: More than 15.7 million hand hygiene events, performed by nearly 11,000 healthcare workers, were captured by the electronic monitoring system and were included in the analysis. Overall, median hand hygiene frequency was 4.1 events per hour and ranged from 2.0 events per hour to 5.6 events per hour, depending on the facility. ABHR use (median, 3.6 events per hour) was more frequent than handwashing (median, 0.4 events per hour). Hospitals included in the analysis ranged from small (<20 beds) rural facilities to large (>600 beds) academic hospitals and provided a variety of services from general medical-surgical treatment to intensive care. Interfacility differences in observed hand hygiene frequency were analyzed. Conclusions: The current analysis reinforces and builds upon previous work that examined a smaller subset of 5 hospitals located in a single geographic region. Combined, these datasets represent >20 million hand hygiene events among ∼15,000 healthcare workers from 16 unique healthcare facilities. This analysis provides detailed information about hand hygiene practices across a diverse set of healthcare facilities.Funding: Ecolab, Inc, provided support for this study.Disclosures: Jessica Carol Albright and Cheryl A Littau report salary from Ecolab.

scholarly journals 1187. Estimation of Individual Healthcare Workers’ Relative Hand Hygiene Compliance Using an Anonymous Electronic Monitoring System

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S425-S426 ◽  
Author(s):  
Maxime-Antoine Tremblay ◽  
Mona Abou Sader ◽  
Yves Longtin
Keyword(s):  
Hand Hygiene ◽  
Monitoring System ◽  
Healthcare Workers ◽  
Electronic Monitoring ◽  
Tertiary Care ◽  
Care Hospital ◽  
Z Score ◽  
Significant Difference ◽  
Z Scores ◽  
Individual Healthcare

Abstract Background The current hand hygiene (HH) auditing and feedback strategy include anonymized data collection using direct observation and feedback of aggregated data. We aimed to evaluate whether an anonymous (without wearable device) HH electronic monitoring system (EMS) could detect patterns associated with individual healthcare workers (HCWs) and estimate their relative HH performance. Methods Observational study of HH compliance via an EMS in 10 rooms in a tertiary care hospital. The EMS measures HH product dispenser activation (an indicator of HH events) as well as entries and exits from patient rooms (a surrogate of HH opportunities). HH rates were obtained by dividing the number of HH events by the number of opportunities. HH rates were aggregated at room-shift level (i.e., an 8-hour period for a single room). For each room-shift, the HH rate was converted to a Z score, which was then associated with the individual HCW assigned to that room-shift. The relative HH performance of individual HCWs was estimated by comparing the mean Z scores of each HCW with the rest of the group by the Student T-test, with a level of significance set at P < 0.001 after adjustment by Bonferroni’s correction. To investigate whether any association could be due to chance, we looked into the potential association between average Z scores and calendar days, as a counterexample. Results Over a 100-day period, there were 45 775 HH events and 136 821 opportunities (global compliance, 33%). Schedules were available for 2980 room-shifts. Fifty-four individual HCWs took part in at least one room-shift (average per HCW, 52 room-shifts; range 1–140). Eight HCWs (15%) had a mean Z score significantly above the group average (Figure 1, green boxes; mean Z score 0.71; range, 0.52 to 0.86; P < 0.001), whereas 9 HCWs (17%) had a significantly inferior Z score (Figure 1, red boxes; mean Z score -0.47, range -0.58 to -0.31, P < 0.001). In contrast, there was no significant difference in Z scores between calendar days (Figure 2; p >0.001). Conclusion Cross-linking a high-volume HH database with HCW schedules identified a significant association between individual HCWs and HH compliance in the rooms to which they were assigned. If confirmed in further studies, anonymous EMS could be used to provide HCWs with personalized relative HH compliance feedback. Disclosures All authors: No reported disclosures.

Unfair treatment, stress and psychological outcomes among correctional healthcare workers.

1999 ◽  
Author(s):  
J. Antonio Escamilla-Cejudo ◽  
Christine D. Karkashian ◽  
Robyn R. M. Gershon ◽  
Larry Murphy
Keyword(s):  
Healthcare Workers ◽  
Psychological Outcomes ◽  
Unfair Treatment ◽  
Correctional Healthcare
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