Assessment of an Aggregate-Level Hand Hygiene Monitoring Technology for Measuring Hand Hygiene Performance Among Healthcare Personnel

2016 ◽  
Vol 38 (3) ◽  
pp. 348-352 ◽  
Author(s):  
Heather M. Limper ◽  
Lynn Slawsky ◽  
Sylvia Garcia-Houchins ◽  
Supriya Mehta ◽  
Ronald C. Hershow ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Gold Standard ◽  
Medical Center ◽  
Healthcare Personnel ◽  
Objective Measures ◽  
Aggregate Level ◽  
Monitoring Technology ◽  
Hospital Unit ◽  
Behavioral Validation ◽  
Technological Methods

BACKGROUNDDespite significant advances in technological methods for hand hygiene surveillance, a lack of evidence prohibits comparison of systems to one another or against the current gold standard of direct observation.OBJECTIVETo validate a hand hygiene monitoring technology (HHMT) designed to capture hand hygiene behaviors aggregated at the hospital-unit level (GOJO Industries, Akron, OH).METHODSOur team followed a rigorous validation approach to assess the sensitivity and positive predictive value (PPV) of an HHMT. A planned path was first used to measure the accuracy of the system when purposefully activated by investigators. Next, behavioral validation was used to quantify accuracy of the system in capturing real-world behaviors.RESULTSDuring the planned path phase, investigators performed 4,872 unique events across 3 distinct hospital buildings varying in size and age since construction. Overall sensitivity across the medical center was 88.7% with a PPV of 99.2%. During the behavioral validation phase, trained direct observers recorded 5,539 unique events across 3 distinct hospital buildings. Overall sensitivity across the medical center was 92.7% and PPV was 84.4%.CONCLUSIONObjective measures of sensitivity and PPV indicate the promise of the benefit of this and other HHMTs to capture basic behaviors associated with hand hygiene.Infect Control Hosp Epidemiol 2017;38:348–352

scholarly journals How Standard Are Standard Precautions? Knowledge and Attitudes Toward Standard Precautions at an Academic Medical Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s254-s254
Author(s):  
Rebecca Faller ◽  
Priya Sampathkumar ◽  
Stacy (Tram) Ung
Keyword(s):  
Hand Hygiene ◽  
Waste Disposal ◽  
Medical Center ◽  
Academic Medical Center ◽  
Significant Proportion ◽  
Healthcare Setting ◽  
Healthcare Personnel ◽  
Standard Precautions ◽  
Respiratory Therapists ◽  
Inpatient Settings

Background: Standard precautions are the basis of infection prevention and include a set of common-sense infection control practices that prevent transmission of diseases acquired by contact with blood, body fluids, nonintact skin, and mucous membranes. These measures include hand hygiene, personal protective equipment (PPE), cleaning and disinfecting, linen handling, waste disposal, sharps safety and respiratory etiquette. Standard precautions require that the risk for exposure be assessed and appropriate precautions taken based on risk. Observations and anecdotal evidence have led us to believe that understanding of standard precautions is lacking among healthcare personnel. Methods: A survey was conducted at a large health system to assess knowledge and practices related to specific elements of standard precautions. Results: More than 3,000 HCWs responded from inpatient settings (41%), outpatient settings (37%), and both settings (22%). Nurses comprised the majority of respondents (54%), and others included physicians (9%), respiratory therapists, as well as physical and occupational therapists. Discussion: The vast majority (96%) of respondents agreed that standard precautions were required in the care of all patients, but a significant proportion (34%) interpreted that to mean that standard precautions always involve wearing gloves, and 22.5% thought that PPE was always required for standard precautions. Hand hygiene and sharps safety were identified as the best understood elements of standard precautions. Respiratory etiquette and cleaning and disinfection were reported as the least understood elements, with PPE, waste disposal, and linen handling also being reported as inadequately understood components of standard precautions (Fig. 1). Conclusions: In an era of increasing drug resistance and fewer effective antibiotics, standard precautions are our best defense against the spread of infections in the healthcare setting. Our survey showed that there is room for improvement among healthcare workers in understanding of the elements of standard precautions. We plan to use the survey to craft a targeted education campaign to improve understanding of and adherence to standard precautions.Funding: NoneDisclosures: None

scholarly journals Sustained Improvement in Hand Hygiene Adherence: Utilizing Shared Accountability and Financial Incentives

2013 ◽  
Vol 34 (11) ◽  
pp. 1129-1136 ◽  
Author(s):  
Thomas R. Talbot ◽  
James G. Johnson ◽  
Claudette Fergus ◽  
John Henry Domenico ◽  
William Schaffner ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Financial Incentives ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Project Planning ◽  
Healthcare Personnel ◽  
Sustained Improvement ◽  
Implementation Phase ◽  
The Impact

Objective.To evaluate the impact of an institutional hand hygiene accountability program on healthcare personnel hand hygiene adherence.Design.Time-series design with correlation analysis.Setting.Tertiary care academic medical center, including outpatient clinics and procedural areas.Participants.Medical center healthcare personnel.Methods.A comprehensive hand hygiene initiative was implemented in 2 major phases starting in July 2009. Key facets of the initiative included extensive project planning, leadership buy-in and goal setting, financial incentives linked to performance, and use of a system-wide shared accountability model. Adherence was measured by designated hand hygiene observers. Adherence rates were compared between baseline and implementation phases, and monthly hand hygiene adherence rates were correlated with monthly rates of device-associated infection.Results.A total of 109,988 observations were completed during the study period, with a sustained increase in hand hygiene adherence throughout each implementation phase (P<.0001) as well as from one phase to the next (P < .0001), such that adherence greater than 85% has been achieved since January 2011. Medical center departments were able to reclaim some rebate dollars allocated through a self-insurance trust, but during the study period, departments did not achieve full reimbursement. Hand hygiene adherence rates were inversely correlated with device-associated standardized infection ratios (R2 = 0.70).Conclusions.Implementation of this multifaceted, observational hand hygiene program was associated with sustained improvement in hand hygiene adherence. The principles of this program could be applied to other medical centers pursuing improved hand hygiene adherence among healthcare personnel.

scholarly journals Healthcare workers' attitudes towards hand-hygiene monitoring technology

2019 ◽  
Vol 102 (4) ◽  
pp. 413-418 ◽  
Author(s):  
C. Tarantini ◽  
P. Brouqui ◽  
R. Wilson ◽  
K. Griffiths ◽  
P. Patouraux ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Monitoring Technology

scholarly journals Hand Hygiene Compliance Study at a Large Central Hospital in Vietnam

2019 ◽  
Vol 16 (4) ◽  
pp. 607 ◽  
Author(s):  
Cam Le ◽  
Erik Lehman ◽  
Thanh Nguyen ◽  
Timothy Craig
Keyword(s):  
Quality Assurance ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Medical Center ◽  
Compliance Rate ◽  
World Health ◽  
Limiting Factors ◽  
Cultural Attitudes ◽  
Knowledge And Attitude ◽  
Hygiene Compliance

Lack of proper hand hygiene among healthcare workers has been identified as a core facilitator of hospital-acquired infections. Although the concept of hand hygiene quality assurance was introduced to Vietnam relatively recently, it has now become a national focus in an effort to improve the quality of care. Nonetheless, barriers such as resources, lack of education, and cultural norms may be limiting factors for this concept to be properly practiced. Our study aimed to assess the knowledge and attitude of healthcare workers toward hand hygiene and to identify barriers to compliance, as per the World Health Organization’s guidelines, through surveys at a large medical center in Vietnam. In addition, we aimed to evaluate the compliance rate across different hospital departments and the roles of healthcare workers through direct observation. Results showed that, in general, healthcare workers had good knowledge of hand hygiene guidelines, but not all believed in receiving reminders from patients. The barriers to compliance were identified as: limited resources, patient overcrowding, shortage of staff, allergic reactions to hand sanitizers, and lack of awareness. The overall compliance was 31%; physicians had the lowest rate of compliance at 15%, while nurses had the highest rate at 39%; internal medicine had the lowest rate at 16%, while the intensive care unit had the highest rate at 40%. In summary, it appears that addressing cultural attitudes in addition to enforcing repetitive quality assurance and assessment programs are needed to ensure adherence to safe hand washing.

scholarly journals Promoting COVID-19 vaccination among healthcare personnel: a multifaceted intervention at a tertiary care center in Japan

2021 ◽  
pp. 1-26
Author(s):  
Akane Takamatsu ◽  
Hitoshi Honda ◽  
Tomoya Kojima ◽  
Kengo Murata ◽  
Hilary Babcock
Keyword(s):  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Vaccination Rate ◽  
Multifaceted Intervention ◽  
Vaccine Hesitancy ◽  
Healthcare Personnel ◽  
Tertiary Care Center ◽  
Post Intervention ◽  
Post Vaccination

Abstract Objective The COVID-19 vaccine may hold the key to ending the pandemic, but vaccine hesitancy is hindering the vaccination of healthcare personnel (HCP). Design Before-after trial Participants and setting Healthcare personnel at a 790-bed tertiary care center in Tokyo, Japan. Interventions A pre-vaccination questionnaire was administered to HCP to examine their perceptions of the COVID-19 vaccine. Then, a multifaceted intervention involving (1) distribution of informational leaflets to all HCP, (2) hospital-wide announcements encouraging vaccination, (3) a mandatory lecture, (4) an educational session about the vaccine for pregnant or breastfeeding HCP, and (5) allergy testing for HCP at risk of allergic reactions to the vaccine was implemented. A post-vaccination survey was also performed. Results Of 1,575 HCP eligible for enrollment, 1,224 (77.7%) responded to the questionnaire, 43.5% (n =533) expressed willingness to be vaccinated, 48.4% (n = 593) were uncertain, and 8.0% (n=98) expressed unwillingness to be vaccinated. The latter two groups were concerned about the vaccine’s safety rather than its efficacy. Post-intervention, the overall vaccination rate reached 89.7% (1,413/1,575), with 88.9% (614/691) of the pre-vaccination survey respondents who answered “unwilling” or “unsure” eventually receiving a vaccination. In the post-vaccination questionnaire, factors contributing to increased COVID-19 vaccination included information and endorsement of vaccination at the medical center (26.4%; 274/1,037). Conclusions The present, multifaceted intervention increased COVID-19 vaccinations among HCP at a Japanese hospital. Frequent support and provision of information were crucial for increasing the vaccination rate and may be applicable to the general population as well.

scholarly journals Quantifying the Risk of Methicillin-Resistant Staphylococcus aureus (MRSA) Transmission From Patient to Healthcare Personnel in the Critical Care Setting

2020 ◽  
Vol 41 (S1) ◽  
pp. s364-s364
Author(s):  
Timileyin Adediran ◽  
Anthony Harris ◽  
J. Kristie Johnson ◽  
Mary-Claire Roghmann ◽  
Stephanie Hitchcok ◽  
...  
Keyword(s):  
Patient Care ◽  
Wound Care ◽  
Medical Center ◽  
Glucose Monitoring ◽  
Routine Care ◽  
Healthcare Personnel ◽  
Medication Delivery ◽  
Care Activity ◽  
The Mean ◽  
Specific Care

Background: Healthcare personnel (HCP) acquire MRSA on their gown and gloves during routine care activities for patients who are colonized or infected with MRSA at a rate of ∼15%. Certain care activities (eg, physical exam, care of endotracheal tube, wound care and bathing/hygiene) have been associated with a higher frequency of transmission from the patient to HCP gown and gloves than other activities (ie, administration of oral medicines, glucose monitoring, and manipulation of IV tubing/medication delivery). However, quantification of MRSA contamination and risk to subsequent patients is poorly defined. Objective: We sought to determine the mean MRSA colony-forming units (CFU) found on the gloves and gowns of HCP who acquire MRSA after various care activities involving patients with MRSA. Methods: We conducted a prospective cohort study at the University of Maryland Medical Center from December 2018 to October 2019. We identified patients colonized or infected with MRSA based on culture data from the prior 7 days. HCP performing prespecified care activities on eligible patients were observed. To isolate the risk of each care activity, HCP donned new gloves and gown prior to a specific care activity. Once that care activity was performed, HCP gloves and gown were swabbed prior to the any further care activities. HCP gloves were cultured with an E-swab by swabbing each digit up and down 3 times followed by 2 circles on the palm of their hands. HCP gowns were sampled by swabbing a 15 × 30-cm area along the beltline of the gown and along each inner forearm twice. E-swab liquid was then serially diluted and plated in triplicate on CHROMagar MRSA II (BD, Sparks, MD) to obtain CFU. We calculated the median CFUs and the interquartile range (IQR) for each specific care activity stratified by gown and gloves. Results: In total, 604 HCP–patient care interactions were observed. Table 1 displays the mean MRSA CFUs stratified by gown and gloves for each patient care activity of interest. Conclusions: The quantity of MRSA found on gowns and gloves varies depending on patient care activities. Recognition of differential transmission rates between various activities may allow different approaches to infection prevention, such as the use of personal protective equipment in high- versus low-risk activities and/or the use of more aggressive interventions for high-risk activities.Funding: NoneDisclosures: None

Objective Measures of Physical Distancing in the Hospital During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Swetha Tatineni ◽  
Nicola M Orlov ◽  
Joseph M Riehm ◽  
Amarachi Erondu ◽  
Christine L Mozer ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Real Time ◽  
Monitoring System ◽  
General Medicine ◽  
Optimal Level ◽  
Objective Measures ◽  
Real Time Monitoring

During the COVID-19 pandemic, hospitals published physical-distancing guidance and created dedicated respiratory isolation units (RIUs) for patients with COVID-19. The degree to which such distancing occurred between clinicians and patients is unknown. In this study, heat sensors from an existing hospital hand-hygiene monitoring system objectively tracked room entries as a proxy for physical distancing in both RIUs and general medicine units before and during the pandemic. The RIUs saw a 60.6% reduction in entries per room per day (from 85.7 to 33.8). General medicine units that cared for patients under investigation for COVID-19 and other patients experienced a 14.7% reduction in entries per room per day (from 76.9 to 65.1). While gradual extinction was observed in both units as COVID-19 cases declined, the RIUs had a higher degree of physical distancing. Although the optimal level of physical distancing is unknown, sustaining physical distancing in the hospital may require re-education and real-time monitoring.

scholarly journals Interventions to improve healthcare workers’ hand hygiene compliance: A systematic review of systematic reviews

2018 ◽  
Vol 39 (12) ◽  
pp. 1449-1456 ◽  
Author(s):  
Lesley Price ◽  
Jennifer MacDonald ◽  
Lucyna Gozdzielewska ◽  
Tracey Howe ◽  
Paul Flowers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hand Hygiene ◽  
Systematic Reviews ◽  
Hand Hygiene Compliance ◽  
Educational Interventions ◽  
Risk Of Bias ◽  
Future Research ◽  
Monitoring Technology ◽  
Positive Effects ◽  
Hygiene Compliance

AbstractObjectiveTo synthesize the existing evidence base of systematic reviews of interventions to improve healthcare worker (HCW) hand hygiene compliance (HHC).MethodsPRISMA guidelines were followed, and 10 information sources were searched in September 2017, with no limits to language or date of publication, and papers were screened against inclusion criteria for relevance. Data were extracted and risk of bias was assessed.ResultsOverall, 19 systematic reviews (n=20 articles) were included. Only 1 article had a low risk of bias. Moreover, 15 systematic reviews showed positive effects of interventions on HCW HHC, whereas 3 reviews evaluating monitoring technology did not. Findings regarding whether multimodal rather than single interventions are preferable were inconclusive. Targeting social influence, attitude, self-efficacy, and intention were associated with greater effectiveness. No clear link emerged between how educational interventions were delivered and effectiveness.ConclusionsThis is the first systematic review of systematic reviews of interventions to improve HCW HHC. The evidence is sufficient to recommend the implementation of interventions to improve HCW HHC (except for monitoring technology), but it is insufficient to make specific recommendations regarding the content or how the content should be delivered. Future research should rigorously apply behavior change theory, and recommendations should be clearly described with respect to intervention content and how it is delivered. Such recommendations should be tested for longer terms using stronger study designs with clearly defined outcomes.

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