Towards Objective Hand Size Assessment and a Standardized Measurement Technique

Bánsághi, Száva; Haidegger, Tamás

doi:10.1109/cinti51262.2020.9305830

Cited by 4 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One physician and the chief nurse were designated to supervise the measurements in the ward. The study was initiated with a one-day-long training, during which the participating healthcare workers (HCWs) received Radiofrequency Identification (RFID) cards for anonymous personal identification, completed a survey, and the size of their hands was recorded [ 32 ]. HCWs were included anonymously in the study on a voluntary basis, and were identified by the number of their RFID cards.…”

Section: Methodsmentioning

confidence: 99%

Establishing a Learning Model for Correct Hand Hygiene Technique in a NICU

Németh

Nádor

Szilágyi

et al. 2022

JCM

View full text Add to dashboard Cite

The ability of healthcare workers to learn proper hand hygiene has been an understudied area of research. Generally, hand hygiene skills are regarded as a key contributor to reduce critical infections and healthcare-associated infections. In a clinical setup, at a Neonatal Intensive Care Unit (NICU), the outcome of a multi-modal training initiative was recorded, where objective feedback was provided to the staff. It was hypothesized that staff at the NICU are more sensitive towards applying increased patient safety measures. Outcomes were recorded as the ability to cover all hand surfaces with Alcohol-Based Handrub (ABHR), modelled as a time-series of measurements. The learning ability to rub in with 1.5 mL and with 3 mL was also assessed. As a secondary outcome, handrub consumption and infection numbers were recorded. It has been observed that some staff members were able to quickly learn the proper hand hygiene, even with the limited 1.5 mL, while others were not capable of acquiring the technique even with 3 mL. When analyzing the 1.5 mL group, it was deemed an insufficient ABHR amount, while with 3 mL, the critical necessity of skill training to achieve complete coverage was documented. Identifying these individuals helps the infection control staff to better focus their training efforts. The training led to a 157% increase in handrub consumption. The setting of the study did not allow to show a measurable reduction in the number of hospital infections. It has been concluded that the training method chosen by the staff greatly affects the quality of the outcomes.

show abstract

Section: Methodsmentioning

confidence: 99%

Establishing a Learning Model for Correct Hand Hygiene Technique in a NICU

Németh

Nádor

Szilágyi

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…Poor quality images were excluded from the evaluation. Hand surface (cm 2 ) assessment was performed according to an already established Automated Area Assessment method [17], which estimates hand size by using a calibration to convert pixel counts to centimetres, and thus considers that the 3D surface of the hands is 1.36× bigger as their two dimensional projections.…”

Section: Hand Size Determinationmentioning

confidence: 99%

“…Recently, more studies investigated whether the addition of a specified volume or hand size-dependent volume would improve efficiency [13][14][15]. Our previous results demonstrated how complete hand coverage highly depends on hand size [16][17][18], and that the currently prescribed 20-30 s application time is unrealistic, as complete hand surface coverage requires longer application times [13,14,18], even if we take into account that different alcohol concentrations of ABHR can affect the drying time [19].…”

Section: Introductionmentioning

confidence: 99%

Evidence-based hand hygiene: Liquid or gel handrub, does it matter?

Voniatis

Bánsághi

Veres

et al. 2023

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

Background Recent studies put under scrutiny the prevailing hand hygiene guidelines, which incorporate quantitative parameters regarding handrub volume and hand size. Understanding the criticality of complete (i.e., efficient) hand hygiene in healthcare, objectivization of hand hygiene related parameters are paramount, including the formulation of the ABHR. Complete coverage can be achieved with optimal Alcohol-Based Hand Rub (ABHR) provided. The literature is limited regarding ABHR formulation variances to antimicrobial efficiency and healthcare workers’ preference, while public data on clinically relevant typical application differences is not available. This study was designed and performed to compare gel and liquid format ABHRs (the two most popular types in Europe) by measuring several parameters, including application time, spillage and coverage. Methodology Senior medical students were invited, and randomly assigned to receive pre-determined ABHR volumes (1.5 or 3 ml). All the 340 participants were given equal amounts of gel and liquid on two separate hand hygiene occasions, which occurred two weeks apart. During the hand hygiene events, by employing a digital, fully automated system paired with fluorescent-traced ABHRs, disinfectant hand coverage was objectively investigated. Furthermore, hand coverage in relation to the participants’ hand sizes was also calculated. Additional data collection was performed regarding volume differences and their effect on application time, participants’ volume awareness (consciousness) and disinfectant spillage during the hand hygiene events. Results The 1.5 ml ABHR volume (commonly applied in healthcare settings) is insufficient in either formulation, as the non-covered areas exceeded significant (5%+) of the total hand surface area. 3 ml, on the contrary, resulted in almost complete coverage (uncovered areas remained below 1.5%). Participants typically underestimated the volume which they needed to apply. While the liquid ABHR spreads better in the lower, 1.5 ml volume compared to the gel, the latter was easier handled at larger volume. Drying times were 30/32 s (gel and liquid formats, respectively) when 1.5 ml handrub was applied, and 40/42 s when 3 ml was used. As the evaporation rates of the ABHR used in the study are similar to those available on the market, one can presume that the results presented in the study apply for most WHO conform ABHRs. Conclusion The results show that applying 1.5 ml volume was insufficient, as large part of the hand surface remained uncovered (7.0 ± 0.7% and 5.8 ± 1.0% of the hand surface in the case of gel and liquid, respectively) When 3 ml handrub was applied drying times were 40 and 42 s (gel and liquid, respectively), which is a very long time in daily clinical practice. It looks like we cannot find a volume that fits for everyone. Personalized, hand size based ABHR volumes may be the solution to find an optimal balance between maximize coverage and minimise spillage and drying time. 3 ml can be a good volume for those who have medium size hands. Large handed people should use more handrub to reach appropriate coverage, while small-handed ones may apply less to avoid massive spillage and not to take unrealistically long to dry.

show abstract

A large-scale investigation of alcohol-based handrub (ABHR) volume: hand coverage correlations utilizing an innovative quantitative evaluation system

Voniatis

Bánsághi

Ferencz

et al. 2021

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

Background Current hand hygiene guidelines do not provide recommendations on a specific volume for the clinical hand rubbing procedure. According to recent studies volume should be adjusted in order to achieve complete coverage. However, hand size is a parameter that highly influences the hand coverage quality when using alcohol-based handrubs (ABHR). The purpose of this study was to establish a quantitative correlation between applied ABHR volume and achieved hand coverage. Method ABHR based hand hygiene events were evaluated utilizing a digital health device, the Semmelweis hand hygiene system with respect to coverage achieved on the skin surface. Medical students and surgical residents (N = 356) were randomly selected and given predetermined ABHR volumes. Additionally, hand sizes were calculated using specialized software developed for this purpose. Drying time, ABHR volume awareness, as well spillage awareness were documented for each hand hygiene event. Results Hand coverage achieved during a hand hygiene event strongly depends on the applied ABHR volume. At a 1 ml dose, the uncovered hand area was approximately 7.10%, at 2 ml it decreased to 1.68%, and at 3 ml it further decreased to 1.02%. The achieved coverage is strongly correlated to hand size, nevertheless, a 3 ml applied volume proved sufficient for most hand hygiene events (84%). When applying a lower amount of ABHR (1.5 ml), even people with smaller hands failed to cover their entire hand surface. Furthermore, a 3 ml volume requires more than the guideline prescribed 20–30 s to dry. In addition, results suggest that drying time is not only affected by hand size, but perhaps other factors may be involved as well (e.g., skin temperature and degree of hydration). ABHR volumes of 3.5 ml or more were inefficient, as the disinfectant spilled while the additional rubbing time did not improve hand coverage. Conclusions Hand sizes differ a lot among HCWs. After objectively measuring participants, the surface of the smallest hand was just over half compared to the largest hand (259 cm2 and 498 cm2, respectively). While a 3 ml ABHR volume is reasonable for medium-size hands, the need for an optimized volume of handrub for each individual is critical, as it offers several advantages. Not only it can ensure adequate hand hygiene quality, but also prevent unnecessary costs. Bluntly increasing the volume also increases spillage and therefore waste of disinfectant in the case of smaller hands. In addition, adherence could potentially decrease due to the required longer drying time, therefore, adjusting the dosage according to hand size may also increase the overall hand hygiene compliance.

show abstract

Towards Objective Hand Size Assessment and a Standardized Measurement Technique

Cited by 4 publications

References 16 publications

Establishing a Learning Model for Correct Hand Hygiene Technique in a NICU

Establishing a Learning Model for Correct Hand Hygiene Technique in a NICU

Evidence-based hand hygiene: Liquid or gel handrub, does it matter?

A large-scale investigation of alcohol-based handrub (ABHR) volume: hand coverage correlations utilizing an innovative quantitative evaluation system

Contact Info

Product

Resources

About