Integrating the SEEV Model with Performance Improvement Methods to Increase Hand Hygiene in the Operating Room

2018 ◽  
Vol 62 (1) ◽  
pp. 1182-1186
Author(s):  
Zach Kaznica ◽  
Orysia Bezpalko ◽  
Grayson Privette ◽  
Kimberly Wilson ◽  
James Won
Keyword(s):  
Hand Hygiene ◽  
Human Factors ◽  
Performance Improvement ◽  
Hand Hygiene Compliance ◽  
Operating Rooms ◽  
Fiscal Year ◽  
Targeted Interventions ◽  
Improvement Methodologies ◽  
Hygiene Compliance ◽  
And Performance

The Main Hospital operating rooms at Children’s Hospital of Philadelphia identified a decrease in hand hygiene compliance during the second half of fiscal year (FY) 2017. To address this, a combined approach of Human Factors and process improvement methodologies was used to increase compliance, with a global aim of achieving 100% compliance by the end of FY 2018. The Human Factors and Performance Improvement team relied upon a combined approached of methodologies and tools including: the SEEV model (Saliency, Effort, Expectancy, and Value), in-person observation, spaghetti diagrams, link analyses, and a survey to gain qualitative and quantitative data to drive the improvement work. Targeted interventions increased hand hygiene compliance in two pilot rooms by nearly 23%; following spread to the rest of the operating rooms, overall compliance was measured at 100%.

Usability of Hand Hygiene Observation Apps

2019 ◽  
Vol 8 (1) ◽  
pp. 275-278
Author(s):  
Amanda Sivek ◽  
Erin Sparnon ◽  
Patrice D Tremoulet
Keyword(s):  
Antibiotic Resistance ◽  
Hand Hygiene ◽  
Mobile Devices ◽  
Clinical Training ◽  
Hand Hygiene Compliance ◽  
Healthcare Associated Infections ◽  
Targeted Interventions ◽  
Hygiene Compliance ◽  
Healthcare Associated ◽  
The U.S

Effective hand hygiene among clinicians decreases the incidence of healthcare-associated infections and helps slow the rate of antibiotic resistance, but hand hygiene compliance (HHC) rates among clinicians is often low. Facility-wide HHC monitoring is required by the U.S. Centers for Medicare & Medicaid Services. In general, HHC monitoring is important to identify facility care areas, units or departments that have low HHC rates so that targeted interventions can be implemented. Recently several hand hygiene observation apps (HHOA), which enable observers to use mobile devices to record HHC data, have become available. The overall goal of our effort was to evaluate how helpful five different HHOAs were in supporting users in collecting and aggregating HHC data. Overall our participants, which included nine individuals with clinical training, and eight biomedical engineers found that all five HHOAs were fairly hard to use given that they have a relatively simple and straightforward function. There was an interesting interaction, however, with the biomedical engineers rating highest the HHOAs that the clinically-trained users rated lowest.

scholarly journals A Decade in Trying to Increase Hand Hygiene—Finally Success

2020 ◽  
Vol 41 (S1) ◽  
pp. s93-s94
Author(s):  
Linda Huddleston ◽  
Sheila Bennett ◽  
Christopher Hermann
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Compliance Rate ◽  
Bloodstream Infections ◽  
Central Line ◽  
Second Phase ◽  
Two Phase ◽  
Hygiene Compliance ◽  
Tract Infections ◽  
The Voice

Background: Over the past 10 years, a rural health system has tried 10 different interventions to reduce hospital-associated infections (HAIs), and only 1 intervention has led to a reduction in HAIs. Reducing HAIs is a goal of nearly all hospitals, and improper hand hygiene is widely accepted as the main cause of HAIs. Even so, improving hand hygiene compliance is a challenge. Methods: Our facility implemented a two-phase longitudinal study to utilize an electronic hand hygiene reminder system to reduce HAIs. In the first phase, we implemented an intervention in 2 high-risk clinical units. The second phase of the study consisted of expanding the system to 3 additional clinical areas that had a lower incidence of HAIs. The hand hygiene baseline was established at 45% for these units prior to the voice reminder being turned on. Results: The system gathered baseline data prior to being turned on, and our average hand hygiene compliance rate was 49%. Once the voice reminder was turned on, hand hygiene improved nearly 35% within 6 months. During the first phase, there was a statistically significant 62% reduction in the average number of HAIs (catheter associated urinary tract infections (CAUTI), central-line–acquired bloodstream infections (CLABSIs), methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant organisms (MDROs), and Clostridiodes difficile experienced in the preliminary units, comparing 12 months prior to 12 months after turning on the voice reminder. In the second phase, hand hygiene compliance increased to >65% in the following 6 months. During the second phase, all HAIs fell by a statistically significant 60%. This was determined by comparing the HAI rates 6 months prior to the voice reminder being turned on to 6 months after the voice reminder was turned on. Conclusions: The HAI data from both phases were aggregated, and there was a statistically significant reduction in MDROs by 90%, CAUTIs by 60%, and C. difficile by 64%. This resulted in annual savings >$1 million in direct costs of nonreimbursed HAIs.Funding: NoneDisclosures: None

scholarly journals Hand hygiene and the sequence of patient care

2021 ◽  
pp. 1-6
Author(s):  
Nai-Chung Chang ◽  
Michael Jones ◽  
Heather Schacht Reisinger ◽  
Marin L. Schweizer ◽  
Elizabeth Chrischilles ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Patient Care ◽  
Intensive Care Units ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Resistant Bacteria ◽  
Surgical Intensive Care ◽  
Hygiene Compliance ◽  
Hand Hygiene Opportunity

Abstract Objective: To determine whether the order in which healthcare workers perform patient care tasks affects hand hygiene compliance. Design: For this retrospective analysis of data collected during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study, we linked consecutive tasks healthcare workers performed into care sequences and identified task transitions: 2 consecutive task sequences and the intervening hand hygiene opportunity. We compared hand hygiene compliance rates and used multiple logistic regression to determine the adjusted odds for healthcare workers (HCWs) transitioning in a direction that increased or decreased the risk to patients if healthcare workers did not perform hand hygiene before the task and for HCWs contaminating their hands. Setting: The study was conducted in 17 adult surgical, medical, and medical-surgical intensive care units. Participants: HCWs in the STAR*ICU study units. Results: HCWs moved from cleaner to dirtier tasks during 5,303 transitions (34.7%) and from dirtier to cleaner tasks during 10,000 transitions (65.4%). Physicians (odds ratio [OR]: 1.50; P < .0001) and other HCWs (OR, 2.15; P < .0001) were more likely than nurses to move from dirtier to cleaner tasks. Glove use was associated with moving from dirtier to cleaner tasks (OR, 1.22; P < .0001). Hand hygiene compliance was lower when HCWs transitioned from dirtier to cleaner tasks than when they transitioned in the opposite direction (adjusted OR, 0.93; P < .0001). Conclusions: HCWs did not organize patient care tasks in a manner that decreased risk to patients, and they were less likely to perform hand hygiene when transitioning from dirtier to cleaner tasks than the reverse. These practices could increase the risk of transmission or infection.

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