The use of real-time feedback via wireless technology to improve hand hygiene compliance

Marra, Alexandre R.; Camargo, Thiago Zinsly Sampaio; Magnus, Thyago Pereira; Blaya, Rosangela Pereira; Santos, Gilson Batista dos; Guastelli, Luciana Reis; Rodrigues, Rodrigo Dias; Prado, Marcelo; Victor, Elivane da Silva; Bogossian, Humberto Bassit; Monte, Julio Cesar Martins; Santos, Oscar Fernando Pavão dos; Oyama, Carlos Kazume; Edmond, Michael B.

doi:10.1016/j.ajic.2014.02.006

Cited by 50 publications

(70 citation statements)

References 19 publications

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“…All rates were computed from the performances of the 513 participants who failed the assessment is better accepted. Real-time feedback was employed in the study, since that is the most efficient tool in behavior change [31,40]. The visualization of missed areas helps students understanding the hand's role in infection transmission [41].…”

Section: Discussionmentioning

confidence: 99%

Education of hand rubbing technique to prospective medical staff, employing UV-based digital imaging technology

Lehotsky

Szilágyi

Demeter-Iclănzan

et al. 2016

Acta Microbiologica et Immunologica Hungarica

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The aim of this study was to objectively assess the hand hygiene performance of medical students. Hand rubbing technique was evaluated by employing innovative UV-light-based imaging technology, identifying patterns and trends in missed areas after applying WHO's six-step protocol. This specially designed hand hygiene education and assessment program targeted 1,344 medical students at two distant sites in Central Europe. Students were introduced to a short video, presenting the basics of hand hygiene, and then received further demonstration from professional trainers, focusing on the correct execution of WHO's six-step technique. To verify the acquired skill, participants rubbed their hands with UV-marked alcohol-based solution. Digital images of the hands were recorded under UV light, followed by computer evaluation and assessment. Immediate objective visual feedback was given to the participants showing missed areas on their hands. The statistical analysis of missed spots was based on retrospective expert-driven manual evaluation. Significant difference in rubbing quality was found between female and male participants [35.3% (CI 95%: 33-38%) versus 29.0% (CI 95%: 27-31%), p < 0.001], dominant and non-dominant hands [43.4% (CI 95%: 39-48%) versus 34.9% (CI 95%: 32-38%), p = 0.002], and various zones of the hands' dorsal side. Based on the participants' feedback and the evaluation of the infection control specialists, it can be stated that the identification of typically missed patterns and the instant visual feedback have a vital role in improving the hand hygiene technique of prospective medical staff. Keywords: hand hygiene assessment, fluorescein trial, medical students training Introduction "Have we forgotten the lesson of Semmelweis?" -stands the question in Lancet [1], referring to the generally weak hand hygiene (HH) performance of physicians in hospitals. Fortunately, the 4% compliance rate reported at a gynecology ward represents an extremely low value [2], but the usually reported rates of 20-50% are still far below expectations [3][4][5]. The main reported reasons for this poor performance include the tight time schedules, forgetfulness, unsatisfactory knowledge on HH guidelines, denying the importance of hands as a source of infection, negative influence of older, more experienced specialists, and skin irritations caused by hand rub solutions [6,7]. Education and training play a vital role in promoting HH [8,9].It is a widely shared concept that the nursing staff shows a better compliance on average than the physicians [3,10]. The unsatisfactory quality of knowledge is clearly supported by the observation that according to physicians' opinion, less HH moments are enough than the amount believed necessary by other healthcare workers [11]. As an interesting analogy, the question of antibiotic resistance is generally believed of high importance by medical students; however, it will be treated superficially during their later work as physicians, similarly to the question of HH [12]. Nurses consider the d...

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Section: Discussionmentioning

confidence: 99%

Education of hand rubbing technique to prospective medical staff, employing UV-based digital imaging technology

Lehotsky

Szilágyi

Demeter-Iclănzan

et al. 2016

Acta Microbiologica et Immunologica Hungarica

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“…The results of this study suggest that a new cycle of the PD approach should be conducted, in which the 4 D's are specifically focused on the team's deficiencies. The addition of these new steps can help professionals improve care processes and advance patient care and safety (11) . The use of sterile cotton-tipped swabs to aid in disinfection entry site and lower region of the CVC fixation dressing was the greatest highlight of this study, both in the frequency of its use and adherence by the nursing team.…”

Section: Discussionmentioning

confidence: 99%

“…Educational processes and health team training are important tools, but it is also necessary to assess CVCrelated care competencies and professional adherence to infection prevention practices (15)(16)(17)(18)(19) . Under these circumstances, the PD approach proved to be fit, given that its interventions focus on individual behavior change (6,11) . Regarding the identification of practices with good outcomes and professionals with PD characteristics (second and third D's), only nursing team professionals proposed PD actions that were implemented and assessed in this study.…”

Section: Discussionmentioning

confidence: 99%

“…In the health area, PD has been used to research hand hygiene practice in interventions with multidisciplinary teams (9)(10)(11)(12) , to assess nursing team adherence to this practice (8) , to involve nurses in the improvement of clinical and administrative outcomes in health systems, and to reduce the incidence of bloodstream infections (20) , among others (5) . All of the steps of this intervention were shared beforehand with local leadership, the hospital infection control committee and the continuing education committee to establish a support network involving both the professionals responsible for providing the necessary resources and conditions and the volunteers who participated in the process.…”

Section: Discussionmentioning

confidence: 99%

“…In the health area, the use of PD has shown good results in studies addressing the most diverse themes, such as patient safety (8) and malaria control (9) . Brazilian researchers have reached successful outcomes by using this strategy in increasing adherence to Hand Hygiene (HH) practices in studies that used new technologies to monitor conformity (10)(11) and also in preventing drug administration errors (12) . In light of the above, the research question was: When used as a proposal for improving work processes related to CVC insertion and management, is positive deviance an effective strategy to prevent and control bloodstream infections?…”

Section: Introductionmentioning

confidence: 99%

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Positive deviance as a strategy to prevent and control bloodstream infections in intensive care

Oliveira

Ferreira

Araújo

et al. 2017

Rev. esc. enferm. USP

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Objective:To describe the application of positive deviance as a strategy to prevent and control bloodstream infections. Method: An intervention study with nursing and medical team members working in an intensive care unit in a university hospital, between June and December 2014. The four steps of the positive defiance methodology were applied: to define, to determine, to discover and to design. Results: In 90 days, 188 actions were observed, of these, 36.70% (n=69) were related to catheter dressing. In 81.15% (n=56) of these dressings, the professionals most adhered to the use of flexible sterile cotton-tipped swabs to perform antisepsis at catheter entry sites and fixation dressing. Conclusion: Positive deviance contributed to the implementation of proposals to improve work processes and team development related to problems identified in central venous catheter care. DESCRIPTORSCentral Venous, Catheters; Infection; Blood Circulation; Nursing Care; Intensive Care Units.Positive deviance as a strategy to prevent and control bloodstream infections in intensive care* Positive Deviance como estratégia na prevenção e controle das infecções de corrente sanguínea na terapia intensiva Positive Deviance como estrategia en la prevención y control de las infecciones de corriente sanguínea en los cuidados intensivos

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Interventions to improve hand hygiene compliance in patient care

Gould

Moralejo

Drey

et al. 2017

Cochrane Database of Systematic Reviews

323

170

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Background Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an e ective preventive measure. This is an update of a previously published review. Objectives To assess the short-and long-term success of strategies to improve compliance to recommendations for hand hygiene, and to determine whether an increase in hand hygiene compliance can reduce rates of health care-associated infection.

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The use of real-time feedback via wireless technology to improve hand hygiene compliance

Cited by 50 publications

References 19 publications

Education of hand rubbing technique to prospective medical staff, employing UV-based digital imaging technology

Education of hand rubbing technique to prospective medical staff, employing UV-based digital imaging technology

Positive deviance as a strategy to prevent and control bloodstream infections in intensive care

Interventions to improve hand hygiene compliance in patient care

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