Secondary measures of hand hygiene performance in health care available with continuous electronic monitoring of individuals.
Compliance
Electronic monitoring
Hand hygiene
Health care acquired
Infection control
Journal
American journal of infection control
ISSN: 1527-3296
Titre abrégé: Am J Infect Control
Pays: United States
ID NLM: 8004854
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
02
05
2018
revised:
03
07
2018
accepted:
05
07
2018
pubmed:
10
9
2018
medline:
21
1
2020
entrez:
10
9
2018
Statut:
ppublish
Résumé
Hand hygiene (HH) compliance in health care is usually measured against versions of the World Health Organization's "Your 5 Moments" guidelines using direct observation. Such techniques result in small samples that are influenced by the presence of an observer. This study demonstrates that continuous electronic monitoring of individuals can overcome these limitations. An electronic real-time prompting system collected HH data on a musculoskeletal rehabilitation unit for 12 weeks between October 2016 and October 2017. Aggregate and professional group scores and the distributions of individuals' performance within groups were analyzed. Soiled utility room exits were monitored and compared with performance at patient rooms. Duration of patient room visits and the number of consecutive missed opportunities were calculated. Overall, 76,130 patient room and 1,448 soiled utility room HH opportunities were recorded from 98 health care professionals. Aggregate unit performance for patient and soiled utility rooms were both 67%, although individual compliance varied greatly. The number of hand wash events that occurred while inside patient rooms increased with longer visits, whereas HH performance at patient room exit decreased. Eighty-three percent of missed HH opportunities occurred as part of a series of missed events, not in isolation. Continuous collection of HH data that includes temporal, spatial, and personnel details provides information on actual HH practices, whereas direct observation or dispenser counts show only aggregate trends.
Sections du résumé
BACKGROUND
Hand hygiene (HH) compliance in health care is usually measured against versions of the World Health Organization's "Your 5 Moments" guidelines using direct observation. Such techniques result in small samples that are influenced by the presence of an observer. This study demonstrates that continuous electronic monitoring of individuals can overcome these limitations.
METHODS
An electronic real-time prompting system collected HH data on a musculoskeletal rehabilitation unit for 12 weeks between October 2016 and October 2017. Aggregate and professional group scores and the distributions of individuals' performance within groups were analyzed. Soiled utility room exits were monitored and compared with performance at patient rooms. Duration of patient room visits and the number of consecutive missed opportunities were calculated.
RESULTS
Overall, 76,130 patient room and 1,448 soiled utility room HH opportunities were recorded from 98 health care professionals. Aggregate unit performance for patient and soiled utility rooms were both 67%, although individual compliance varied greatly. The number of hand wash events that occurred while inside patient rooms increased with longer visits, whereas HH performance at patient room exit decreased. Eighty-three percent of missed HH opportunities occurred as part of a series of missed events, not in isolation.
CONCLUSIONS
Continuous collection of HH data that includes temporal, spatial, and personnel details provides information on actual HH practices, whereas direct observation or dispenser counts show only aggregate trends.
Identifiants
pubmed: 30195406
pii: S0196-6553(18)30745-4
doi: 10.1016/j.ajic.2018.07.004
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
38-44Subventions
Organisme : CIHR
ID : MOP-102687
Pays : Canada
Informations de copyright
Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.