Efficacy of observational hand hygiene audit with targeted feedback on doctors' hand hygiene compliance: A retrospective time series analysis.
Observational hand hygiene audit
audit
compliance
doctor
feedback
hand hygiene
Journal
Journal of infection prevention
ISSN: 1757-1774
Titre abrégé: J Infect Prev
Pays: England
ID NLM: 101469725
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
14
08
2018
accepted:
30
12
2018
entrez:
21
8
2019
pubmed:
21
8
2019
medline:
21
8
2019
Statut:
ppublish
Résumé
Healthcare-associated infection compromises patient safety. Compliance with hand hygiene (HH) guidelines has been shown to be an effective method of reducing infection; however, it remains suboptimal and poorer among doctors compared to other healthcare workers. The aim of this study is to determine the relationship between an individualised observational hand hygiene audit (OHHA) and feedback intervention with observed HH compliance. We used a retrospective interrupted time series design using OHHA data from a five-year period, 2011-2015. OHHA indicated poorer HH compliance among doctors than other healthcare workers in a 345-bed acute private hospital. An increase in orthopaedic surgical site infection prompted additional auditing of the orthopaedic unit further identifying substandard HH compliance among orthopaedic surgeons. In addition to ongoing HH interventions, an individualised hand hygiene audit and feedback intervention focusing on consultant orthopaedic surgeons was implemented. Observed HH compliance improved. The intervention was then extended to include all consultant doctors at the study site. Audit was implemented by trained clinical nurse managers during clinical rounds. Written audit feedback was provided by the infection prevention and control team. HH compliance increased significantly among both orthopaedic surgeons and other consultant doctors, An individualised audit and feedback intervention was effective in improving compliance. Incorporation of OHHA with individualised feedback into routine daily practice needs to be considered as a quality improvement opportunity. This study has the potential to inform other audit and feedback interventions to maximise effectiveness and ensure implementation.
Sections du résumé
BACKGROUND
BACKGROUND
Healthcare-associated infection compromises patient safety. Compliance with hand hygiene (HH) guidelines has been shown to be an effective method of reducing infection; however, it remains suboptimal and poorer among doctors compared to other healthcare workers. The aim of this study is to determine the relationship between an individualised observational hand hygiene audit (OHHA) and feedback intervention with observed HH compliance.
METHODS
METHODS
We used a retrospective interrupted time series design using OHHA data from a five-year period, 2011-2015. OHHA indicated poorer HH compliance among doctors than other healthcare workers in a 345-bed acute private hospital. An increase in orthopaedic surgical site infection prompted additional auditing of the orthopaedic unit further identifying substandard HH compliance among orthopaedic surgeons. In addition to ongoing HH interventions, an individualised hand hygiene audit and feedback intervention focusing on consultant orthopaedic surgeons was implemented. Observed HH compliance improved. The intervention was then extended to include all consultant doctors at the study site. Audit was implemented by trained clinical nurse managers during clinical rounds. Written audit feedback was provided by the infection prevention and control team.
RESULTS
RESULTS
HH compliance increased significantly among both orthopaedic surgeons and other consultant doctors,
CONCLUSION
CONCLUSIONS
An individualised audit and feedback intervention was effective in improving compliance. Incorporation of OHHA with individualised feedback into routine daily practice needs to be considered as a quality improvement opportunity. This study has the potential to inform other audit and feedback interventions to maximise effectiveness and ensure implementation.
Identifiants
pubmed: 31428196
doi: 10.1177/1757177419833165
pii: 10.1177_1757177419833165
pmc: PMC6683608
doi:
Types de publication
Journal Article
Langues
eng
Pagination
164-170Déclaration de conflit d'intérêts
Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Références
Lancet. 2000 Oct 14;356(9238):1307-12
pubmed: 11073019
Implement Sci. 2006 Apr 28;1:9
pubmed: 16722539
Infect Control Hosp Epidemiol. 2010 Mar;31(3):283-94
pubmed: 20088678
Infect Control Hosp Epidemiol. 2011 Feb;32(2):101-14
pubmed: 21460463
Am J Infect Control. 2011 Nov;39(9):716-24
pubmed: 21664001
Euro Surveill. 2012 Nov 15;17(46):null
pubmed: 23171822
J Clin Epidemiol. 2014 Mar;67(3):267-77
pubmed: 24275499
Implement Sci. 2014 Jan 17;9:14
pubmed: 24438584
BMJ. 2014 Mar 07;348:g1687
pubmed: 24609605
Med J Aust. 2014 May 19;200(9):534-7
pubmed: 24835717
J Gen Intern Med. 2014 Nov;29(11):1534-41
pubmed: 24965281
BMC Infect Dis. 2014 Nov 18;14:611
pubmed: 25407783
Am J Infect Control. 2015 Mar 1;43(3):269-74
pubmed: 25728153
Am J Med Qual. 2016 Nov;31(6):577-583
pubmed: 26201665
Crit Care. 2015 Aug 14;19:292
pubmed: 26271619
Lancet Infect Dis. 2016 Dec;16(12):1345-1355
pubmed: 27599874
J Hosp Infect. 2018 Oct;100(2):176-182
pubmed: 29654810
J Infect Prev. 2018 May;19(3):108-113
pubmed: 29796092
Am J Infect Control. 2019 Jul;47(7):798-803.e1
pubmed: 30711350