scholarly journals Psychomotor learning theory informing the design and evaluation of an interactive augmented reality hand hygiene training app for healthcare workers

2021 ◽  
Author(s):  
Gerard Lacey ◽  
Lucyna Gozdzielewska ◽  
Kareena McAloney-Kocaman ◽  
Jonathan Ruttle ◽  
Sean Cronin ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Hand Hygiene ◽  
World Health Organisation ◽  
World Health ◽  
Psychomotor Skills ◽  
Healthcare Organizations ◽  
Improve Hand Hygiene ◽  
Training Tool ◽  
Independent Evaluation ◽  
Skills Learning

AbstractHand hygiene is critical for infection control, but studies report poor transfer from training to practice. Hand hygiene training in hospitals typically involves one classroom session per year, but psychomotor skills require repetition and feedback for retention. We describe the design and independent evaluation of a mobile interactive augmented reality training tool for the World Health Organisation (WHO) hand hygiene technique. The design was based on a detailed analysis of the underlying educational theory relating to psychomotor skills learning. During the evaluation forty-seven subjects used AR hand hygiene training over 4 weeks. Hand hygiene proficiency was assessed at weekly intervals, both electronically and via human inspection. Thirty eight participants (81%) reached proficiency after 24.3 (SD = 17.8) two-minute practice sessions. The study demonstrated that interactive mobile applications could empower learners to develop hand hygiene skills independently. Healthcare organizations could improve hand hygiene quality by using self-directed skills-based training combined with regular ward-based assessments.

scholarly journals Identification of factors associated with hand hygiene adherence as a support for creating curriculum for nurses training – a multivariate analysis

2020 ◽  
Vol 89 (3) ◽  
pp. e444
Author(s):  
Anna Garus-Pakowska
Keyword(s):  
Multivariate Analysis ◽  
Hand Hygiene ◽  
Infection Prevention ◽  
Participant Observation ◽  
Univariate Analysis ◽  
World Health Organisation ◽  
World Health ◽  
Important Conclusion ◽  
Average Value ◽  
Educational Programmes

Aim. Handwashing is the easiest way to prevent infection but is often neglected. The purpose of the study was to identify the barriers limiting the respect for hygiene procedures by nurses. Material and Methods. The study involved direct quasi-participant observation and a questionnaire of 11 nurses in six wards of three hospitals in Poland. Results. In total,1,195 observations were conducted in which 3,355 activities requiring hygiene procedures were observed over 8 months. The nurses’ knowledge of proper hand hygiene and infection prevention principles were unsatisfactory, with an average value of correct answers in the knowledge test of 8.7 (Max = 15). The univariate analysis indicated the following barriers in hand hygiene: emergencies, allergies, or too few dispensers. In multivariate analysis, the application of hygiene procedures depended on the level of education (higher education – worse compliance with the rules) and subjective conviction that handwashing/glove use was important. Conclusion. Educational programmes on hand hygiene should focus on the World Health Organisation indications that glove use is not a substitute for handwashing.

scholarly journals Training to Proficiency in the WHO Hand Hygiene Technique

2019 ◽  
Vol 6 ◽  
pp. 238212051986768
Author(s):  
Gerard Lacey ◽  
Mary Showstark ◽  
James Van Rhee
Keyword(s):  
Hand Hygiene ◽  
Training Program ◽  
Clinical Skills ◽  
World Health ◽  
Strongly Correlated ◽  
Improve Hand Hygiene ◽  
Health Care Associated Infections ◽  
Low Performance ◽  
Health Organization ◽  
Training Exercises

Objectives: Hand hygiene is critical to patient safety, but low performance in terms of the quantity and quality of hand hygiene is often reported. Training-to-proficiency is common for other clinical skills, but no proficiency-based training program for hand hygiene has been reported in the literature. This study developed a proficiency-based training program to improve hand hygiene quality in line with World Health Organization (WHO) guidelines and assessed the amount of training required to reach proficiency. The training was delivered as part of a 5-day induction for students on the Physician Assistant online program. Methods: A total of 42 students used a simulator to objectively measure hand hygiene technique over a 5-day period. Proficiency was achieved when students demonstrated all 6 steps of the WHO technique in less than 42 seconds. The students also completed a postintervention questionnaire. Results: The average training episode lasted 2.5 minutes and consisted of 4.5 hand hygiene exercises. The average student completed 5 training episodes (1 per day) taking a total of 17 minutes. A total of 40% (17) of the students achieved proficiency within the 5 days. Proficiency was strongly correlated with the number of training exercises completed ( r = 0.79, P < .001) and the total time spent training ( r = 0.75, P < .001). Linear regression predicted that the 32 hand hygiene exercises or a total of 23-minute training were required to achieve proficiency. Conclusions: This is the first study to develop a train-to-proficiency program for hand hygiene quality and estimate the amount of training required. Given the importance of hand hygiene quality to preventing health care–associated infections (HAIs), medical education programs should consider using proficiency-based training in hand hygiene technique.

scholarly journals The impact of interventions to improve compliance in hand hygiene – a prospective study from Sangre Grande Hospital

2018 ◽  
Author(s):  
Rajeev Nagassar ◽  
Roma Bridgelal-Nagassar ◽  
Keston Daniel ◽  
Lima Harper
Keyword(s):  
Hand Hygiene ◽  
Prospective Study ◽  
Compliance Rate ◽  
Hospital Setting ◽  
Educational Interventions ◽  
World Health ◽  
Post Intervention ◽  
Improve Hand Hygiene ◽  
A Prospective Study ◽  
The Impact

Objectives To assess the compliance of hand hygiene (HH) practices of staff and determine the impact of multimodal interventions to improve hand hygiene practices. Methods A prospective study was conducted to determine the hand hygiene (HH) practices of staff according to the World Health Organization’s “5 moments of HH”. During random visits to the general wards, HH practices of staff were observed for 41 weeks during 2014-15. During the first 8 weeks, the basic compliance rate (BCR) was calculated. A BCR of 50% or more was considered compliant. Data were provided to the staff via email. Toolbox talks, posters, and other educational interventions were instituted in a multimodal manner. Wards were visited by infection control staff to reinforce HH practices. During the post-intervention phase, the HH practices were reassessed for 33 weeks to compare the impact of interventions. Results A total of 13,120 observations were made. Participants ranged from ages 18 to 65. The overall average BCR before intervention was 34.1%, for the first 8 weeks, while it increased to 62.3%, over the next 33 weeks, after the multimodal interventions (p =0.007). The wards which showed significant improvement include Paediatrics (p <0.0001), Male Surgical (p = 0.001), Female Surgical (p = 0.005), Male Medical (p < 0.0001), Haemodialysis Unit (p < 0.0001), ICU, (p = 0.038), and Accident and Emergency (p = 0.007). Obstetric, Female Medical, and Oncology wards did not show statistically significant improvement. Conclusion Hand Hygiene compliance rate of staff can be improved by multimodal interventions in a General Hospital setting.

scholarly journals Safe Hands: teaching innovation project to improve hand hygiene in health sciences.

2015 ◽  
Author(s):  
Jacobo Cambil-Martin
Keyword(s):  
Patient Safety ◽  
Hand Hygiene ◽  
Health Sciences ◽  
World Health ◽  
Improve Hand Hygiene ◽  
Hand Hygiene Improvement ◽  
Teaching Innovation ◽  
Multimodal Strategy ◽  
The World ◽  
Innovation Project

Background: Since 2004, the World Alliance for Patient Safety brings proposing hand hygiene as the key measure of its international strategy in the fight against healthcare-associated infections. In Spain the Safe Hands Distinction of the Patient Safety Observatory recognizes the good practices on improving hand hygiene of the World Health Organization. Objectives: Apply the WHO multimodal strategy to improve hand hygiene at the Faculty of Health Sciences and maintain the culture of Patient Safety on hand hygiene by students and staff. Methods: A teaching innovation project called "Safe Hands" was developed in the Nursing Degree at the Faculty of Health Sciences of the University of Granada during the academic period 2013-2015. The tool "Guide to the Implementation of the WHO Multimodal Hand Hygiene Improvement Strategy" served to develop and plan the program to improve hand hygiene according to its five phases. In parallel, activities were implemented according to the three stages of the accreditation process "Safe Hands Distinction". Results: The Faculty of Health Sciences has become a dynamic secure environment that provides alcoholic gel for practice and training on hand hygiene, disseminates information and updated signage, reinforces the training of students and staff, and reinforces the quality assurance project. Study Limitations: It is necessary to complete the five years cycle of continuous improvement in quality of the WHO guide to establish an optimal strategy for improving hand hygiene. Conclusion: Safe Hands has launched the WHO multimodal strategy in an academic context. The Faculty of Health Sciences has got credited the Safe Hands Distinction, becoming the first Higher Education Center accredited in Spain to improve hand hygiene.

scholarly journals Behavioural Determinants of Hand Washing and Glove Recontamination before Aseptic Procedures at Birth: A Time-and-Motion Study and Survey in Zanzibar Labour Wards

2020 ◽  
Vol 17 (4) ◽  
pp. 1438 ◽  
Author(s):  
Giorgia Gon ◽  
Sandra Virgo ◽  
Mícheál de Barra ◽  
Said M. Ali ◽  
Oona M. Campbell ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
World Health Organisation ◽  
Hand Washing ◽  
World Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Hand Rubbing ◽  
Time And Motion ◽  
Motion Study

Recent research calls for distinguishing whether the failure to comply with World Health Organisation hand hygiene guidelines is driven by omitting to rub/wash hands, or subsequently recontamination of clean hands or gloves prior to a procedure. This study examined the determinants of these two behaviours. Across the 10 highest-volume labour wards in Zanzibar, we observed 103 birth attendants across 779 hand hygiene opportunities before aseptic procedures (time-and-motion methods). They were then interviewed using a structured cross-sectional survey. We used mixed-effect multivariable logistic regressions to investigate the independent association of candidate determinants with hand rubbing/washing and avoiding glove recontamination. After controlling for confounders, we found that availability of single-use material to dry hands (OR:2.9; CI:1.58–5.14), a higher workload (OR:29.4; CI:12.9–67.0), more knowledge about hand hygiene (OR:1.89; CI:1.02–3.49), and an environment with more reminders from colleagues (OR:1.20; CI:0.98–1.46) were associated with more hand rubbing/washing. Only the length of time elapsed since donning gloves (OR:4.5; CI:2.5–8.0) was associated with avoiding glove recontamination. We identified multiple determinants of hand washing/rubbing. Only time elapsed since washing/rubbing was reliably associated with avoiding glove recontamination. In this setting, these two behaviours require different interventions. Future studies should measure them separately.

scholarly journals The effect of training and awareness of subtle control on the frequency of hand hygiene among intensive care unit nurses

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Zeinab Farmani ◽  
Marzieh Kargar ◽  
Zahra Khademian ◽  
Shahram Paydar ◽  
Najaf Zare
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Intervention Group ◽  
World Health ◽  
Control Group ◽  
Chi Square ◽  
Improve Hand Hygiene ◽  
The Mean ◽  
Hygiene Compliance

Abstract Objective This study aimed to determine the effect of awareness of subtle control after training on the hand hygiene compliance among nurses in intensive care units (ICUs). The study was conducted in two ICUs of a trauma center in Shiraz, Iran on 48 nurses. The nurses of one ICU were randomly allocated to the intervention and the nurses of the other ICU were allocated to the control group. All nurses were trained on hand hygiene. Then a fake closed camera television (CCTV) was visibly installed in the intervention group’s ICU, while the nurses were aware of it. The degree of compliance with hand hygiene was observed in both groups before and after the intervention. Data were gathered using a checklist based on the World Health Organization hand hygiene protocol and analyzed using SPSS 16 and the Chi square, Wilcoxon, Mann–Whitney U, and Independent T-tests, were performed. Results The mean percentage of hand hygiene compliance in the intervention group after the intervention was significantly higher than before the intervention (p < 0.001). Additionally, the changes in the mean percentage of the intervention group was significantly higher than that for the control group (p = 0.001). The findings showed that a fake CCTV after training, installed in ICUs, can improve hand hygiene compliance.

Improving hand hygiene compliance with patient zone demarcation: More than just lines on the floor

2018 ◽  
Vol 24 (3) ◽  
pp. 100-107 ◽  
Author(s):  
Shanqing Yin ◽  
Phaik Kooi Lim ◽  
Yoke Hwee Chan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Time Pressure ◽  
World Health ◽  
Post Intervention ◽  
Improve Hand Hygiene ◽  
Positive Effects ◽  
Hygiene Compliance

Background Hand hygiene compliance can be difficult to improve as this prospective activity may not come to mind easily during busy clinical operations. Clinicians are often driven by clinical goals under time pressure, and the sudden recall to clean hands can either be disruptive or too late. Using patient zones as a reference has been known to be helpful. A low-tech solution of taping patient zones on the floor was introduced in a children’s intensive care unit. Coupled with this demarcation is a simplified protocol that uses patient zones for “just-in-time” reminders. Clinicians now clean their hands whenever they cross zone lines, namely “ before patient zone” and “ after patient zone”, along with “ before aseptic procedure” and “ after bodily fluids exposure”. Methods The mandatory national quarterly hand hygiene surveillance data for children’s intensive care unit and the entire hospital was tracked. Seven pre-intervention and seven post-intervention quarters were compared for improvement and sustainability. Results Overall, children’s intensive care unit hand hygiene compliance rose from an average of 77% to 90%, as well as physicians' hand hygiene compliance rates from 72% to 86%, and these differences are statistically significant. Hand Hygiene Moment 1 as defined by World Health Organization benefited the most from this intervention. Discussion Patient zone demarcation, along with more intuitive hand hygiene guidelines, is a cost-effective, operationally sensitive intervention that can improve hand hygiene compliance. The bundled solution taps on human factors science in understanding the cognitive challenges faced by clinicians. The positive effects are most profound in multi-bed cubicles where patient zones and infection control barriers are not clearly visible.

Improving Hand Hygiene Practices in a Rural Hospital in Sub-Saharan Africa

2016 ◽  
Vol 37 (7) ◽  
pp. 834-839 ◽  
Author(s):  
Ian C. Holmen ◽  
Celestin Seneza ◽  
Berthine Nyiranzayisaba ◽  
Vincent Nyiringabo ◽  
Mugisha Bienfait ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Low Income ◽  
Rural Hospital ◽  
Sub Saharan Africa ◽  
World Health ◽  
Post Intervention ◽  
Improve Hand Hygiene ◽  
Quasi Experimental ◽  
Sub Saharan

OBJECTIVETo improve hand hygiene (HH) compliance among physicians and nurses in a rural hospital in sub-Saharan Africa (SSA) using the World Health Organization’s (WHO’s) Guidelines on Hand Hygiene in Health Care.DESIGNThis study was a quasi-experimental design divided into 4 phases: (1) preparation of materials and acquisition of the hospital administration’s support, (2) baseline evaluation, (3) intervention, and (4) follow-up evaluation.SETTINGA 160-bed, non-referral hospital in Gitwe, RwandaPARTICIPANTSA total of 12 physicians and 54 nurses participated in this study.METHODSThe intervention consisted of introducing locally produced alcohol-based hand rub (ABHR); educating healthcare workers (HCWs) on proper HH practice; providing pocket-sized ABHR bottles for HCWs; placing HH reminders in the workplace; and surveying HCWs at surrounding health centers regarding HH compliance barriers. Hand hygiene infrastructure, compliance, and knowledge were assessed among physicians and nurses using baseline observations and a follow-up evaluation survey.RESULTSOverall, HH compliance improved from 34.1% at baseline to 68.9% post intervention (P<.001), and HH knowledge was significantly enhanced (P<.001). The 3 departments included in this study had only 1 sink for 29 patient rooms, and 100% of HH opportunities used ABHR. Hand hygiene compliance was significantly higher among physicians than nurses both before and after the intervention. All measures of HH compliance improved except for “after body fluid exposure,” which was 51.7% before intervention and 52.8% after intervention (P>.05).CONCLUSIONHand hygiene campaigns using WHO methods in SSA have been implemented exclusively in large, referral hospitals. This study shows that an HH program using the WHO tools successfully improved HH in a low-income, rural hospital in SSA.Infect Control Hosp Epidemiol2016;37:834–839

scholarly journals IMPLEMENTATION OF WHO HAND HYGIENE IMPROVEMENT STRATEGY IN TRNAVA UNIVERSITY HOSPITAL, SLOVAKIA

10.23856/3710 ◽  
2020 ◽  
Vol 37 (6) ◽  
pp. 99-106
Author(s):  
Janka Prnová ◽  
Jaroslava Brňová ◽  
Viera Rusnáková
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Daily Basis ◽  
University Hospital ◽  
World Health ◽  
Improvement Strategy ◽  
Improve Hand Hygiene ◽  
Hand Hygiene Improvement ◽  
Hygiene Compliance ◽  
The Impact

Hand hygiene is considered to be the most simple, effective and economic measure to prevent the spread of healthcare-associated infections and antimicrobial resistance. Based on the study, application of the World Health Organization’s Multimodal Hand Hygiene Improvement Strategy can improve hand hygiene compliance in hospital settings and reduce these infections. Trnava University Hospital was included to World Health Organization (WHO) launched a worldwide campaign focused on hand hygiene in 2013, when infection control specialist has started working on daily basis. Our objective was to evaluate the impact of implementing the Multimodal Hand Hygiene Strategy according to WHO. We assessed alcohol-based hand rub consumption during the period 2013 and 2018 and hand hygiene compliance in 2018 as a baseline. During observed period alcohol-based hand rub consumptions significantly increased from 15.7 L/1000 patient days to 24.3 L/1000 patient days (p<0.05). Overall compliance as per WHO guidelines were 38.9%.

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