scholarly journals Accurate Measurement of Handwash Quality Using Sensor Armbands: Instrument Validation Study (Preprint)

2019 ◽  
Author(s):  
Chaofan Wang ◽  
Zhanna Sarsenbayeva ◽  
Xiuge Chen ◽  
Tilman Dingler ◽  
Jorge Goncalves ◽  
...  
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Cost Effective ◽  
Video Data ◽  
World Health ◽  
Detection Accuracy ◽  
Cost Effective Method ◽  
Health Care Associated Infections ◽  
Dependent Model ◽  
Health Organization

BACKGROUND Hand hygiene is a crucial and cost-effective method to prevent health care–associated infections, and in 2009, the World Health Organization (WHO) issued guidelines to encourage and standardize hand hygiene procedures. However, a common challenge in health care settings is low adherence, leading to low handwashing quality. Recent advances in machine learning and wearable sensing have made it possible to accurately measure handwashing quality for the purposes of training, feedback, or accreditation. OBJECTIVE We measured the accuracy of a sensor armband (Myo armband) in detecting the steps and duration of the WHO procedures for handwashing and handrubbing. METHODS We recruited 20 participants (10 females; mean age 26.5 years, SD 3.3). In a semistructured environment, we collected armband data (acceleration, gyroscope, orientation, and surface electromyography data) and video data from each participant during 15 handrub and 15 handwash sessions. We evaluated the detection accuracy for different armband placements, sensor configurations, user-dependent vs user-independent models, and the use of bootstrapping. RESULTS Using a single armband, the accuracy was 96% (SD 0.01) for the user-dependent model and 82% (SD 0.08) for the user-independent model. This increased when using two armbands to 97% (SD 0.01) and 91% (SD 0.04), respectively. Performance increased when the armband was placed on the forearm (user dependent: 97%, SD 0.01; and user independent: 91%, SD 0.04) and decreased when placed on the arm (user dependent: 96%, SD 0.01; and user independent: 80%, SD 0.06). In terms of bootstrapping, user-dependent models can achieve more than 80% accuracy after six training sessions and 90% with 16 sessions. Finally, we found that the combination of accelerometer and gyroscope minimizes power consumption and cost while maximizing performance. CONCLUSIONS A sensor armband can be used to measure hand hygiene quality relatively accurately, in terms of both handwashing and handrubbing. The performance is acceptable using a single armband worn in the upper arm but can substantially improve by placing the armband on the forearm or by using two armbands. CLINICALTRIAL

scholarly journals Accurate Measurement of Handwash Quality Using Sensor Armbands: Instrument Validation Study

10.2196/17001 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e17001 ◽  
Author(s):  
Chaofan Wang ◽  
Zhanna Sarsenbayeva ◽  
Xiuge Chen ◽  
Tilman Dingler ◽  
Jorge Goncalves ◽  
...  
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Cost Effective ◽  
Video Data ◽  
World Health ◽  
Detection Accuracy ◽  
Cost Effective Method ◽  
Health Care Associated Infections ◽  
Dependent Model ◽  
Health Organization

Background Hand hygiene is a crucial and cost-effective method to prevent health care–associated infections, and in 2009, the World Health Organization (WHO) issued guidelines to encourage and standardize hand hygiene procedures. However, a common challenge in health care settings is low adherence, leading to low handwashing quality. Recent advances in machine learning and wearable sensing have made it possible to accurately measure handwashing quality for the purposes of training, feedback, or accreditation. Objective We measured the accuracy of a sensor armband (Myo armband) in detecting the steps and duration of the WHO procedures for handwashing and handrubbing. Methods We recruited 20 participants (10 females; mean age 26.5 years, SD 3.3). In a semistructured environment, we collected armband data (acceleration, gyroscope, orientation, and surface electromyography data) and video data from each participant during 15 handrub and 15 handwash sessions. We evaluated the detection accuracy for different armband placements, sensor configurations, user-dependent vs user-independent models, and the use of bootstrapping. Results Using a single armband, the accuracy was 96% (SD 0.01) for the user-dependent model and 82% (SD 0.08) for the user-independent model. This increased when using two armbands to 97% (SD 0.01) and 91% (SD 0.04), respectively. Performance increased when the armband was placed on the forearm (user dependent: 97%, SD 0.01; and user independent: 91%, SD 0.04) and decreased when placed on the arm (user dependent: 96%, SD 0.01; and user independent: 80%, SD 0.06). In terms of bootstrapping, user-dependent models can achieve more than 80% accuracy after six training sessions and 90% with 16 sessions. Finally, we found that the combination of accelerometer and gyroscope minimizes power consumption and cost while maximizing performance. Conclusions A sensor armband can be used to measure hand hygiene quality relatively accurately, in terms of both handwashing and handrubbing. The performance is acceptable using a single armband worn in the upper arm but can substantially improve by placing the armband on the forearm or by using two armbands.

scholarly journals Impact of Hand Hygiene on Hospital-Acquired Infection Rate in Neuro Trauma ICU at a Level 1 Trauma Center in the National Capital Region of India

2021 ◽  
Author(s):  
Sandeep Boora ◽  
Parul Singh ◽  
Roshni Dhakal ◽  
Dennis Victor ◽  
Jacinta Gunjiyal ◽  
...  
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Cost Effective ◽  
World Health ◽  
National Capital Region ◽  
Hospital Acquired Infection ◽  
Cost Effective Method ◽  
Care Workers ◽  
National Capital ◽  
Hospital Acquired

Abstract Introduction Compliance to hand hygiene (HH) is an important measure in preventing infections to patients in health-care settings. Wellness and safety of patients and health-care workers (HCWs) can be achieved by promoting best practices in infection control through education and advocacy. Aims and Objectives To assess the compliance to HH among all cadres of HCWs and its association with hospital-acquired infection (HAI) in patients. Materials and Methods A prospective, observational study was conducted for a period of 5 years (January 2014 to December 2018) in Neuro Trauma intensive care unit. A standard checklist based on World Health Organization’s 5 Moments for Hand Hygiene was used as a tool to measure the HH compliance. Results HAI rate was found to be directly proportional to the compliance to HH. Reduction in HAI rates was reported when there was an increase in HH compliance. HAI of 4.25% was found to be lowest in the year 2015 with the compliance to HH of 63.65%. The HH compliance was also found to be highest (64.63%) in the year 2016 followed by 64.12% in the year 2017. During this period HAI rates were 4.35% and 4.8%, respectively. When the HH compliance declined in the year 2018 to 53.95%, there was an increase in the rate of HAI to 6.9%. Conclusion It could be concluded that HH compliance was associated with the decrease in HAIs. HH could be a simple and cost-effective method in the prevention of HAIs.

Essential medicines for palliative care

2015 ◽  
Author(s):  
Liliana De Lima ◽  
Lukas Radbruch ◽  
Eduardo Bruera
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
International Association ◽  
Cost Effective ◽  
Access To Medicines ◽  
Essential Medicines ◽  
World Health ◽  
Care Needs ◽  
Health Organization ◽  
Hospice And Palliative Care

The essential medicines concept developed by the World Health Organization (WHO), states that there is a list of minimum medicines for a basic health-care system, including the most efficacious, safe, and cost-effective ones for priority conditions. According to the WHO, essential medicines are those that satisfy the primary health-care needs of the population. Thus, they should always be available, affordable, and cost-effective. However, the vast majority of the global population does not have access to essential medicines. Many organizations have called on governments to adopt policies to improve availability of these essential medicines and developed programmes and projects to increase awareness and knowledge. This chapter describes two such projects developed by the International Association for Hospice and Palliative Care (IAHPC), based on the essential medicines concept to improve access to medicines and appropriate palliative care: the IAHPC List of Essential Medicines in Palliative Care and the Opioid Essential Prescription Package.

scholarly journals Hand hygiene compliance among rural healthcare workers of Nepal

2018 ◽  
Vol 5 (1) ◽  
pp. 90-95
Author(s):  
Ajay Kumar Rajbhandari ◽  
Reshu Agrawal Sagtani ◽  
Kedar Prasad Baral
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Compliance Rate ◽  
Hand Washing ◽  
World Health ◽  
Cross Sectional ◽  
Hygiene Compliance ◽  
Health Organization ◽  
Healthcare Associated

Introductions: Transmission of healthcare associated infections through contaminated hands of healthcare workers are common. This study was designed to explore the existing compliance of hand hygiene among the healthcare workers workings in different level of health care centers of Makwanpur district of Nepal. Methods: This was a cross sectional observational study conducted in Makwanpur district, Nepal, during 2015. Healthcare workers from nine healthcare centers were selected randomly for the study. Standard observation checklists and World Health Organization guidelines on hand hygiene were used to assess the compliance of hand hygiene during patient care. Results: There were 74 participants. Overall compliance for hand washing was 24.25% (range 19.63 to 45.56). Complete steps of hand washing were performed by 38.3% of health care workers. The factors associated for noncompliance were lack of time (29.3%), example set by seniors (20%), absence or inadequate institution protocol (20%) and unfavourable health care setting (> 20%). Conclusions: Overall hand washing compliance rate amongst the healthcare workers in rural health facilities of Nepal were low (24.25%).

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 Hospital knowledge and practice of doctors and nurses regarding hand hygiene in a survey

2020 ◽  
pp. 119-132
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Health Care Professionals ◽  
Scientific Evidence ◽  
Health Care Facilities ◽  
World Health ◽  
The Difference ◽  
Health Organization ◽  
Healthcare Associated ◽  
The Impact

INTRODUCTION. The guidelines issued by the World Health Organization (WHO) in 2009 regarding hand hygiene (HH) in health care provided health care professionals with scientific evidence that argued that HH principles should be respected when dealing with patients. Despite the passage of years and strenuous attempts to introduce these recommendations to the Polish health care facilities for the prevention of healthcare-associated infections (HAI), these principles are still not being implemented in an optimal way for the patient’s safety. OBJECTIVE OF WORK. The aim was to examine the views and attitudes of physicians (L) and nurses (P) towards the WHO rules of hand hygiene. MATERIAL AND METHODS. The study was performed by means of a diagnostic survey using a questionnaire of our own design; random sampling was used. The study involved 231 LP: 173 (74.9%) women, 58 (25.1%) men, including 93 (40.3%) doctors and 138 (59.7%) nurses. The study was conducted in a multiprofile hospital in Małopolska in 2017. The difference between what the respondents think (their views) and what they do in reality (what attitudes they display) was examined in relation to WHO principles, such as wearing natural short nails and jewelry on their hands. RESULTS. Negative practice of observing these HH principles in relation to views was detected (R = -0.014, p<0.05, R2 = 0.016). Respondents supported the view that the ring could affect HAI and rarely used it in practice, the practice was positive (R = 0.298, p <0.001, R2 = 0.085). Women strongly emphasized the view that wearing long nails has an impact on HAI spread, but in practice they often declared keeping long nails, practice was negative (R = -0.241, p <0.01, R2 = 0.054). In response to the question about the impact of nail painting on the spread of HAI, this view was poorly represented, in practice some of them wore painted nails, the practice was negative (R = -0.226, p <0.01, R2 = 0.045). CONCLUSION. Despite high support for the principles of hand hygiene, in practice, these principles were not always respected, the impact on the practice was negative in areas such as: general adherence to the HH principles, wearing long and painted nails. The compatibility of views with practice was detected in relation to wearing a wedding ring.

Hand Hygiene and Infection Control

Nursing OSCEs ◽  
2012 ◽  
Author(s):  
Jane Lovegrove
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Hand Hygiene ◽  
World Health ◽  
Health Care Students ◽  
Physical Burden ◽  
Health Organization ◽  
The Uk ◽  
Heath Care ◽  
Hospital Acquired

Each year hundreds of millions of people contract an infection while in the receipt of heath care. At any time 1.4 million people worldwide are suffering from an infectious complication associated with health care (WHO 2005). Health care acquired infections not only lead to pain discomfort, disability, and possible death for the recipient but also place a huge emotional and physical burden on relatives and carers. In England and Wales an average of one in 11,000 people die of a hospital acquired infection (HAI) each year; this figure rises to 1 in 300 for patients over the age of 80 (Bandolier 2006). Hospital admission is now a major risk factor for health care related infection (Gould 2009). In 2007 around 9,000 people in England died with an MRSA bloodstream infection or related Clostridium difficile infection (National Audit Office 2009). These figures do not include deaths from other HAIs so in fact the number of deaths from HAIs could be greater. In addition, it is also believed that many people die from a health care acquired infection which is not identified on the death certificate. In England, health care related infections have been estimated to cost a billion pounds annually (WHO 2005). The World Health Organization has identified hand hygiene as the primary measure to reduce infections (WHO 2009). Everyone involved in the provision of health care must be trained in effective hand decontamination (NICE 2003). Unclean hands move microorganisms from one place to another. Transmission of infection by hands has been identified with recent hospital outbreaks of MRSA and Clostridium difficile. Good hand hygiene is one of the most effective methods of reducing hospital acquired infections. Hand decontamination removes transient bacteria acquired from recent contact with an infected item or person. While hand decontamination is advocated before contact with every patient regardless of setting, patients in hospital are at greatest risk of acquiring an infection. In the UK 7.6% of patients admitted to hospital become infected. In England the figure is even higher at 8.19% (Nazarko 2008). It is essential for health care students to not only be able to perform effective hand washing, but also understand the principles of the procedure, as well as the possible physical, emotional and financial consequences of failing to perform hand hygiene.

scholarly journals Hand Hygiene Practices among Medical Students

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Azzam al Kadi ◽  
Sajad Ahmad Salati
Keyword(s):  
Medical Students ◽  
Hand Hygiene ◽  
Cost Effective ◽  
World Health ◽  
Undergraduate Medical Students ◽  
Clinical Phase ◽  
Healthcare Settings ◽  
Hygiene Practices ◽  
Cost Effective Method ◽  
Significant Difference

Background. Hand hygiene is a cost-effective method in preventing infection transmission. Hand hygiene practices have been found to be faulty in most healthcare settings. We conducted a study to evaluate the awareness, and compliance of hand hygiene among undergraduate medical students during their clinical phase in Qassim College of Medicine, Saudi Arabia.Methods. A questionnaire based on World Health Organization’s concept of “Five Moments for Hand Hygiene” was used to evaluate the awareness of the indications for hand hygiene and compliance was observed during Objective Structured Clinical Examination (OSCE) sessions. Sixty students including thirty-six males (60%) and twenty-four females (40%) participated voluntarily in the study.Results. The average awareness regarding the positive indications of hand hygiene was 56%. Rest of the 44% of students were either not sure or unaware of the indications of hygiene. Only 29% of students were able to identify all the five indications for hand hygiene in the questionnaire. Compliance as assessed during OSCE sessions was only 17% with no significant difference between the genders.Conclusion. It was concluded that serious efforts are needed to improve the hand hygiene practices among medical students.

scholarly journals Educational sessions may not be enough to improve knowledge about hand hygiene: Assessing the knowledge about hand hygiene of health workers before and after an educational workshop in Sudan

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 449 ◽  
Author(s):  
Ihab B. Abdalrahman ◽  
Sara Shamat ◽  
Sara Mamoun ◽  
Reem Abdelraheem ◽  
Esraa Salah ◽  
...  
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Health Workers ◽  
Public Hospitals ◽  
World Health ◽  
Improvement Project ◽  
Before And After ◽  
Health Organization ◽  
Almost All ◽  
Educational Workshop

Background: In an attempt to defeat the high prevalence of health care associated infections, by raising the awareness about hand hygiene, we implemented a quasi-experimental study as part of a quality improvement project to evaluate the efficacy of focused educational workshop on knowledge about hand hygiene among health care workers in Sudan. Methods: Seventy-three participants were recruited from two public hospitals and one private hospital in Khartoum, Sudan in September 2017. The knowledge before and after the educational workshop was assessed for each participant using the World Health Organization hygiene associated infection questionnaire. We analyzed data using SPSS v22 and used McNemar’s test to compare knowledge before and after the workshop. Results: Around 40% of participants worked in general ward and 85% of them were women. Almost 70% were midwives or nurses. The mean age of participants was 28.4 years. We compared the knowledge of hand hygiene between nurses and doctors before the workshop, and the results showed that nurses had better knowledge in almost all aspects of hand hygiene. When we compared the knowledge before and immediately after the workshop for all participants, we found that there was no significant improvement in almost all aspects of knowledge about hand hygiene (P>0.05). Conclusion: Comparing the knowledge before and after the workshop, we found no significant improvement in almost all aspects of hand hygiene. Of note, nurses’ knowledge about hand hygiene was consistently higher than doctors.  Additional studies are needed to identify the optimal design of educational sessions.

scholarly journals Breeding and agronomic approaches for the biofortification of zinc in wheat (Triticum aestivum L.) to combat zinc deficiency in millions of a population: a Bangladesh perspective

2019 ◽  
Vol 72 (2) ◽  
Author(s):  
Shilpi Das ◽  
Apurbo Kumar Chaki ◽  
Akbar Hossain
Keyword(s):  
Cost Effective ◽  
Triticum Aestivum L ◽  
Essential Elements ◽  
World Health ◽  
Zn Deficiency ◽  
Cost Effective Method ◽  
The World ◽  
Health Organization ◽  
Deficiency Diseases ◽  
Maize Research Institute

The World Health Organization (WHO) has estimated that around 2 billion people across the globe are suffering from “hidden hunger”, where 815 million are under malnutrition. The major essential elements for humans are Fe, Zn, I, Se, Ca, F, and also vitamins. Among them, Zn is considered in the fifth place leading to causes of several deficiency diseases. At least one-third of the population in the world is facing Zn deficiency including around 450,000 children under the age of five. Vitamin A, Fe, and Zn deficiencies can be overcome through the biofortification of staple foodstuffs. This review emphasizes various breeding and agronomic approaches for the biofortification of Zn in wheat grains, which is an encouraging and cost-effective method to enhance the Zn contents of cereal grains. Recently, the Bangladesh Wheat and Maize Research Institute (BWMRI), with technical support from CIMMYT, Mexico, released a promising new Zn-biofortified wheat cultivar, ‘BARI Gom 33’, a result from a conventional breeding program. It has 32 and 50–55 mg kg<sup>−1</sup> Zn without and with soil application of ZnSO<sub>4</sub>, respectively. This cultivar could be a savior for a million people in South Asia, including Bangladesh.

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