Development and validation of a time and motion guide to assess the costs of prevention and control interventions for nosocomial infections: A Delphi method among experts

Abstract

Background Nosocomial infections place a heavy burden on patients and healthcare providers and impact health care institutions financially. Reducing nosocomial infections requires an integrated program of prevention and control using key clinical best care practices. No instrument currently exists that measures these practices in terms of personnel time and material costs. Objective To develop and validate an instrument that would measure nosocomial infection control and prevention best care practice costs, including estimates of human and material resources. Methods An evaluation of the literature identified four practices essential for the control of pathogens: hand hygiene, hygiene and sanitation, screening and additional precaution. To reflect time, materials and products used in these practices, our team developed a time and motion guide. Iterations of the guide were assessed in a Delphi technique; content validity was established using the content validity index and reliability was assessed using Kruskall Wallis one-way ANOVA of rank test. Results Two rounds of Delphi review were required; 88% of invited experts completed the assessment. The final version of the guide contains eight dimensions: Identification [83 items]; Personnel [5 items]; Additional Precautions [1 item]; Hand Hygiene [2 items]; Personal Protective Equipment [14 items]; Screening [4 items]; Cleaning and Disinfection of Patient Care Equipment [33 items]; and Hygiene and Sanitation [24 items]. The content validity index obtained for all dimensions was acceptable (> 80%). Experts statistically agreed on six of the eight dimensions. Discussion/Conclusion This study developed and validated a new instrument based on expert opinion, the time and motion guide, for the systematic assessment of costs relating to the human and material resources used in nosocomial infection prevention and control. This guide will prove useful to measure the intensity of the application of prevention and control measures taken before, during and after outbreak periods or during pandemics such as COVID-19.

Comparison of Improved Surgical Eight-Step Handwashing Combined with ATP Fluorescence in Detecting the Infection Rate at the Site of Seven-Step Surgical Handwashing and 30-Day Orthopaedic Surgery: A Randomized Study

“…In the 19th century, Semmelweis first noted the link between hospital-acquired diseases and hand hygiene [ 4 ]. Nosocomial infection places a heavy burden on patients and health care providers and economically affects health care institutions [ 5 ]. Hand is the main carrier of transmitting bacteria, viruses, and microorganisms.…”

Patient and family views of team functioning in primary healthcare teams with nurse practitioners: a survey of patient-reported experience and outcomes

“…The implementation of evidence-informed strategies to support role clarity and to develop non-technical skills, such as communication, is crucial when issues are identified. Interventions, including debriefing, structured communications, and speaking-up, show promise to improve team functioning [ 47 ]. Further, the co-development of an implementation plan with key stakeholders including patients, families, care providers, and decision-makers can support role clarification in teams [ 23 ].…”

Standardized and validated training to support the charge nurse: Research protocol

“…Participants will evaluate: the training content; the relevance of the transfer of training and the organizational structure methods proposed to administer the training. Experts will be able to evaluate the content on a Likert scale with four response options from 1 = ‘not relevant’ to 4 = ‘very relevant without corrections’ as shorter Likert scales have produced stable findings in a previous Delphi study (Tchouaket Nguemeleu et al, 2020). Also, space will be provided for open‐ended commentary. Step 6: The feedback will be consolidated and analysed.…”