Observer accuracy and behavior analysis: Data collection procedures on hand hygiene compliance in a neurovascular unit

Accuracy of paper-and-pencil systematic observation versus computer-aided systems

Computer-aided behavior observation is gradually supplanting paper-and-pencil approaches to behavior observation, but there is a dearth of evidence on the relative accuracy of paper-and-pencil versus computer-aided behavior observation formats in the literature. The current study evaluated the accuracy resulting from paper-and-pencil observation and from two computer-aided behavior observation methods: The Observer XT® desktop software and the Big Eye Observer® smartphone application. Twelve postgraduate students without behavior observation experience underwent a behavior observation training protocol. As part of a multi-element design, participants recorded 60 real clinical sessions randomly assigned to one of the three observation methods. All three methods produced high levels of accuracy (paper-and-pencil, .88 ± .01; The Observer XT, .84 ± .01; Big Eye Observer, .84 ± .01). A mixed linear model analysis indicated that paper-and-pencil observation produced marginally superior accuracy values, whereas the accuracy produced by The Observer XT and Big Eye Observer did not differ. The analysis suggests that accuracy of recording was mediated by the number of recordable events in the observation videos. The implications of these findings for research and practice are discussed.

Evaluating healthcare workers' hand hygiene performance using first-person view video observation in a standardized patient-care scenario

BACKGROUND

Monitoring healthcare workers' (HCWs) hand hygiene (HH) performance is recommended for improving compliance. Observer biases challenge data validity, thus supplemental approaches such as video observation are needed to complement monitoring.

METHODS

We investigate first-person view (FPV) video observation during simulated standardized patient care handling a catheter in a study with 71 HCWs. HH performance was evaluated for (1) all HH opportunities and (2) a subset of opportunities required in an ideal work sequence, hereafter core opportunities. HCWs' acceptance of FPV video observation and usability judgments were assessed.

RESULTS

Compliance level for core HH opportunities (M = 43.5%) was significantly higher than compliance considering all opportunities (M = 30.4%, t(70) = 8.493, P < .001). Reducing HH opportunities to core opportunities would significantly increase compliance levels from the observed average of 30.4% to 44.9% (t(70) = 12.822, P < .001). Overall, both usability ratings and acceptance of the body camera were promising.

DISCUSSION

FPV video observation in simulated standardized patient care provides new instruments to evaluate HH performance beyond mere compliance rates. Our results emphasize the role of optimizing workflow in order to improve HCW's HH compliance.

CONCLUSIONS

FPV video observation in a standardized patient care simulation is feasible and offers information for HH interventions that target actual deficiencies.

Data Consistency Theory and Case Study for Scientific Big Data

Big data technique is a series of novel technologies to deal with large amounts of data from various sources. Unfortunately, it is inevitable that the data from different sources conflict with each other from the aspects of format, semantics, and value. To solve the problem of conflicts, the paper proposes data consistency theory for scientific big data, including the basic concepts, properties, and quantitative evaluation method. Data consistency can be divided into different grades as complete consistency, strong consistency, weak consistency, and conditional consistency according to consistency degree and application demand. The case study is executed on material creep testing data. The analysis results show that the theory can solve the problem of conflicts in scientific big data.

Electronic monitoring in combination with direct observation as a means to significantly improve hand hygiene compliance

Monitoring hand hygiene compliance among health care personnel (HCP) is an essential element of hand hygiene promotion programs. Observation by trained auditors is considered the gold standard method for establishing hand hygiene compliance rates. Advantages of observational surveys include the unique ability to establish compliance with all of the World Health Organization "My 5 Moments for Hand Hygiene" initiative Moments and to provide just-in-time coaching. Disadvantages include the resources required for observational surveys, insufficient sample sizes, and nonstandardized methods of conducting observations. Electronic and camera-based systems can monitor hand hygiene performance on all work shifts without a Hawthorne effect and provide significantly more data regarding hand hygiene performance. Disadvantages include the cost of installation, variable accuracy in estimating compliance rates, issues related to acceptance by HCP, insufficient data regarding their cost-effectiveness and influence on health care-related infection rates, and the ability of most systems to monitor only surrogates for Moments 1, 4, and 5. Increasing evidence suggests that monitoring only Moments 1, 4, and 5 provides reasonable estimates of compliance with all 5 Moments. With continued improvement of electronic monitoring systems, combining electronic monitoring with observational methods may provide the best information as part of a multimodal strategy to improve and sustain hand hygiene compliance rates among HCP.