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Boyce JM, Pittet D. Rinse, gel, and foam - is there any evidence for a difference in their effectiveness in preventing infections? Antimicrob Resist Infect Control 2024; 13:49. [PMID: 38730473 PMCID: PMC11084031 DOI: 10.1186/s13756-024-01405-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/01/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Following publication of the 2009 World Health Organizations Guidelines for Hand Hygiene in Health Care, a debate has emerged regarding the relative antimicrobial efficacy of the different formats (rinse, gel, foam) of ABHRs and their ability to contribute to reduction of healthcare-associated infections (HAIs). METHODS Data regarding the in-vivo antimicrobial efficacy of ABHRs and other factors that likely affect their effectiveness in reducing HAIs were reviewed, and a comprehensive review of studies that reported the effectiveness of each of the three ABHR formats to improve hand hygiene compliance and reduce HAIs was conducted. RESULTS The amount of rubbing time it takes for hands to feel dry (dry time) is the major driver of ABHR antimicrobial efficacy. ABHR format is not a major factor, and several studies found that rinse, gel, and foam ABHRs have comparable in-vivo antimicrobial efficacy. Other factors that likely impact the ability of ABHRs to reduce transmission of healthcare-associated pathogens and HAIs include ABHR formulation, the volume applied to hands, aesthetic characteristics, skin tolerance, acceptance by healthcare personnel, and hand hygiene compliance rates. When accompanied by complementary strategies, promoting the use of each of the three ABHR formats has been associated with improvements in hand hygiene compliance rates. A review of 67 studies failed to identify an ABHR format that was significantly more effective in yielding statistically significant reductions in transmission of healthcare-associated pathogens or HAIs. CONCLUSIONS Current evidence is insufficient to definitively determine if one ABHR format is more effective in reducing transmission of healthcare-associated pathogens and HAIs. More rigorous studies such as multicenter randomized controlled trials comparing the different formats are needed to establish if one format is significantly more effective in reducing HAIs.
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Affiliation(s)
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Minotti C, Aghlmandi S, Bielicki JA. Electronic hand hygiene monitoring tools for implementation of optimal hand sanitizing adherence in neonatal intensive care. J Hosp Infect 2024; 147:213-215. [PMID: 38447807 DOI: 10.1016/j.jhin.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Affiliation(s)
- C Minotti
- Paediatric Research Centre, University Children's Hospital Basel, Basel, Switzerland; Infectious Disease and Vaccinology, University Children's Hospital Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland.
| | - S Aghlmandi
- Paediatric Research Centre, University Children's Hospital Basel, Basel, Switzerland
| | - J A Bielicki
- Paediatric Research Centre, University Children's Hospital Basel, Basel, Switzerland; Infectious Disease and Vaccinology, University Children's Hospital Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland; Centre for Neonatal and Paediatric Infection, St George's, University of London, London, UK
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3
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Boyce JM. Current issues in hand hygiene. Am J Infect Control 2023; 51:A35-A43. [PMID: 37890952 DOI: 10.1016/j.ajic.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Multiple aspects of hand hygiene have changed in recent years. METHODS A PubMed search was conducted to identify recent articles about hand hygiene. RESULTS The COVID-19 pandemic caused temporary changes in hand hygiene compliance rates and shortages of alcohol-based hand sanitizers (ABHSs), and in marketing of some products that were ineffective or unsafe. Fortunately, ABHSs are effective against SARS-CoV-2 and other emerging pathogens including Candida auris and mpox. Proper placement, maintenance, and design of ABHS dispensers have gained additional attention. Current evidence suggests that if an adequate volume of ABHS has been applied to hands, personnel must rub their hands together for at least 15 seconds before hands feel dry (dry time), which is the primary driver of antimicrobial efficacy. Accordingly, practical methods of monitoring hand hygiene technique are needed. Direct observation of hand hygiene compliance remains a challenge in many healthcare facilities, generating increased interest in automated hand hygiene monitoring systems (AHHMSs). However, several barriers have hindered widespread adoption of AHHMSs. AHHMSs must be implemented as part of a multimodal improvement program to successfully improve hand hygiene performance rates. CONCLUSIONS Remaining gaps in our understanding of hand hygiene warrant continued research into factors impacting hand hygiene practices.
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Affiliation(s)
- John M Boyce
- J.M. Boyce Consulting, LLC, Middletown, CT, USA.
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Glowicz JB, Landon E, Sickbert-Bennett EE, Aiello AE, deKay K, Hoffmann KK, Maragakis L, Olmsted RN, Polgreen PM, Trexler PA, VanAmringe MA, Wood AR, Yokoe D, Ellingson KD. SHEA/IDSA/APIC Practice Recommendation: Strategies to prevent healthcare-associated infections through hand hygiene: 2022 Update. Infect Control Hosp Epidemiol 2023; 44:355-76. [PMID: 36751708 DOI: 10.1017/ice.2022.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The purpose of this document is to highlight practical recommendations to assist acute-care hospitals in prioritization and implementation of strategies to prevent healthcare-associated infections through hand hygiene. This document updates the Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals through Hand Hygiene, published in 2014. This expert guidance document is sponsored by the Society for Healthcare Epidemiology (SHEA). It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association, and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.
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Tseng C, He X, Chen W, Tseng CL. Evaluating automatic hand hygiene monitoring systems: A scoping review. Public Health Pract (Oxf) 2022; 4:100290. [PMID: 36588768 PMCID: PMC9801014 DOI: 10.1016/j.puhip.2022.100290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/11/2022] [Accepted: 06/23/2022] [Indexed: 01/04/2023] Open
Abstract
Objectives To categorize the extant automatic hand hygiene monitoring systems (AHHMSs) and evaluate the capacity of each to provide information on compliance rates. Study design Scoping review. Methods Three international databases, PubMed, CINAHL, and EBSCO (between 1 January 2010 and 31 December 2020), were searched according to predetermined inclusion criteria for the scoping review. Two authors screened studies for eligibility independently. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Results Twenty-seven studies were included. Three types of AHHMSs were identified: Type I provides information about the aggregate hand hygiene events (HHEs) only, while Type II adds aggregate hand hygiene opportunities (HHOs), and Type III presents both HHEs and HHOs for individuals. Results suggested that improving the accuracy of recording HHEs and/or HHOs was critical for improving the accuracy of the compliance, which could increase the acceptability of the monitoring system. In addition, the studies found that the implementation of AHHMSs, especially with prompt reminders or additional interventions, could improve the compliance significantly. Conclusions The extant AHHMSs could be decomposed into components of 3Ps (product usage monitoring, position monitoring, and performance monitoring). By identifying devices and technology as well as the type of information provided for each component, our approach can aid healthcare facilities to choose a suitable AHHMS that meets their criteria.
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Affiliation(s)
- Cynthia Tseng
- Johns Hopkins University Applied Physics Laboratory, Maryland, USA
| | - Xueying He
- University of Electronic Science and Technology of China, Shenzhen, China
| | - Wenlin Chen
- University of Electronic Science and Technology of China, Chengdu, China,Corresponding author. No.2006, Xiyuan Ave, West Hi-Tech Zone, 611731, Chengdu, Sichuan, China.
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6
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Wang C, Jiang W, Yang K, Yu D, Newn J, Sarsenbayeva Z, Goncalves J, Kostakos V. Electronic Monitoring Systems for Hand Hygiene: Systematic Review of Technology. J Med Internet Res 2021; 23:e27880. [PMID: 34821565 PMCID: PMC8663600 DOI: 10.2196/27880] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 09/04/2021] [Accepted: 10/04/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hand hygiene is one of the most effective ways of preventing health care-associated infections and reducing their transmission. Owing to recent advances in sensing technologies, electronic hand hygiene monitoring systems have been integrated into the daily routines of health care workers to measure their hand hygiene compliance and quality. OBJECTIVE This review aims to summarize the latest technologies adopted in electronic hand hygiene monitoring systems and discuss the capabilities and limitations of these systems. METHODS A systematic search of PubMed, ACM Digital Library, and IEEE Xplore Digital Library was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were initially screened and assessed independently by the 2 authors, and disagreements between them were further summarized and resolved by discussion with the senior author. RESULTS In total, 1035 publications were retrieved by the search queries; of the 1035 papers, 89 (8.60%) fulfilled the eligibility criteria and were retained for review. In summary, 73 studies used electronic monitoring systems to monitor hand hygiene compliance, including application-assisted direct observation (5/73, 7%), camera-assisted observation (10/73, 14%), sensor-assisted observation (29/73, 40%), and real-time locating system (32/73, 44%). A total of 21 studies evaluated hand hygiene quality, consisting of compliance with the World Health Organization 6-step hand hygiene techniques (14/21, 67%) and surface coverage or illumination reduction of fluorescent substances (7/21, 33%). CONCLUSIONS Electronic hand hygiene monitoring systems face issues of accuracy, data integration, privacy and confidentiality, usability, associated costs, and infrastructure improvements. Moreover, this review found that standardized measurement tools to evaluate system performance are lacking; thus, future research is needed to establish standardized metrics to measure system performance differences among electronic hand hygiene monitoring systems. Furthermore, with sensing technologies and algorithms continually advancing, more research is needed on their implementation to improve system performance and address other hand hygiene-related issues.
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Affiliation(s)
- Chaofan Wang
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Weiwei Jiang
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Kangning Yang
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Difeng Yu
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Joshua Newn
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Zhanna Sarsenbayeva
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Jorge Goncalves
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Vassilis Kostakos
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
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Hoang D, Khawar N, George M, Gad A, Sy F, Narula P. Video didactic at the point of care impacts hand hygiene compliance in the neonatal intensive care unit (NICU). J Healthc Risk Manag 2018; 37:9-15. [PMID: 29405485 DOI: 10.1002/jhrm.21314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To increase the hand-washing (HW) duration of staff and visitors in the NICU to a minimum of 20 seconds as recommended by the CDC. METHODS Intervention included video didactic triggered by motion sensor to play above wash basin. Video enacted Centers for Disease Control and Prevention (CDC) HW technique in real time and displayed timer of 20 seconds. HW was reviewed from surveillance video. Swabs of hands plated and observed for qualitative growth (QG) of bacterial colonies. RESULTS In visitors, the mean HW duration at baseline was 16.3 seconds and increased to 23.4 seconds at the 2-week interval (p = .003) and 22.9 seconds at the 9-month interval (p < .0005). In staff, the mean HW duration at baseline was 18.4 seconds and increased to 29.0 seconds at 2-week interval (p = .001) and 25.7 seconds at the 9-month interval (p < .0005). In visitors, HW compliance at baseline was 33% and increased to 52% at the 2-week interval (p = .076) and 69% at the 9-month interval (p = .001). In staff, HW compliance at baseline was 42% and increased to 64% at the 2-week interval (p = .025) and 72% at the 9-month interval (p = .001). Increasing HW was significantly associated with linear decrease in bacterial QG. CONCLUSIONS The intervention significantly increased mean HW time, compliance with a 20-econd wash time and decreased bacterial QG of hands and these results were sustained over a 9-month period.
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Affiliation(s)
- Danthanh Hoang
- New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY
| | - Nayaab Khawar
- New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY
| | - Maria George
- New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY
| | - Ashraf Gad
- New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY
| | - Farrah Sy
- New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY
| | - Pramod Narula
- New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY
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Araújo FLD, Manzo BF, Costa ACL, Corrêa ADR, Marcatto JDO, Simão DADS. Adherence to central venous catheter insertion bundle in neonatal and pediatric units. Rev Esc Enferm USP 2017; 51:e03269. [PMID: 29185601 DOI: 10.1590/s1980-220x2017009603269] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 07/19/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To describe the observed behavior of professionals in two neonatal and pediatric intensive care units regarding the use of central venous catheter insertion bundle, and the clinical and birth profile of neonates and children who received the devices. METHOD A quantitative descriptive exploratory study was conducted in two intensive care units of a public hospital in Belo Horizonte with neonates and children, between February and September 2016. RESULTS The sample consisted of 59 observed implants of central venous catheter. Most patients were male preterm infants, of cesarean delivery and proper weight according to the gestational age. Among all procedures observed, only three followed all recommendations for the central venous catheter insertion bundle. Incorrect techniques were observed while performing surgical antisepsis and inadequate use of chlorhexidine, an antiseptic. CONCLUSION The findings highlight the importance of more investment in continuous training of the team on the prevention of bloodstream infection caused by central venous catheter to reduce the number of adverse events related to intravenous therapy.
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Boyce JM. Electronic monitoring in combination with direct observation as a means to significantly improve hand hygiene compliance. Am J Infect Control 2017; 45:528-35. [PMID: 28456322 DOI: 10.1016/j.ajic.2016.11.029] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/26/2016] [Accepted: 11/27/2016] [Indexed: 01/16/2023]
Abstract
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.
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Scheithauer S, Batzer B, Dangel M, Passweg J, Widmer A. Workload even affects hand hygiene in a highly trained and well-staffed setting: a prospective 365/7/24 observational study. J Hosp Infect 2017; 97:11-16. [PMID: 28389091 DOI: 10.1016/j.jhin.2017.02.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 02/12/2017] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Compliance with hand hygiene (HH) has often not proved satisfactory; high workload is a commonly self-reported reason. Previous studies comparing workload and compliance have not measured workload precisely and have focused on certain times of day. This study aimed to investigate the association between HH compliance and workload, both electronically defined 365/7/24 (primary endpoint). In addition, the quality of commonly used compliance defining methods (hand disinfectant usage, direct observation) was investigated (secondary endpoint). MATERIALS AND METHODS Correlation of electronically measured HH compliance (hand-rub activities (HRA)/HH opportunities) with electronically determined workload (nursing time output/nursing time input) was undertaken over one year at a stem cell transplant unit at University Hospital Basel, Switzerland. HRA and procedures requiring HRA according to the five World Health Organization indications were recorded continuously (365/7/24) using electronic dispensers and electronic documentation, and compliance was calculated accordingly. Hand disinfectant usage was calculated using spending records for one year; direct observation was performed for approximately 1800 HH opportunities. RESULTS During the investigation, 208,184 HRA, translating into 57 [standard deviation (SD) 10] HRA/patient-day (PD), were performed. Electronically determined compliance ranged from 24% to 66% [mean 42.39% (SD 8%)]. The higher the workload, the lower the compliance (R=-0.411; P<0.001). HRA/PD (r=-0.037), hand disinfectant usage (mean 160mL/PD) and observed compliance (95%; 1734 HRA/1813 HH opportunities) were not found to be associated with workload. CONCLUSION Calculated compliance was inversely associated with nurses' workload. HRA/PD, observer-determined compliance and amount of disinfectant dispensed were used as surrogates for compliance, but did not correlate with actual compliance and thus should be used with caution.
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Affiliation(s)
- S Scheithauer
- Infection Control and Infectious Diseases, University Medicine Goettingen, University Goettingen, Germany; Infectious Diseases, Basel University Hospital, Basel, Switzerland.
| | - B Batzer
- Infectious Diseases, Basel University Hospital, Basel, Switzerland
| | - M Dangel
- Infectious Diseases, Basel University Hospital, Basel, Switzerland
| | - J Passweg
- Clinic for Haematology, Basel University Hospital, Basel, Switzerland
| | - A Widmer
- Infectious Diseases, Basel University Hospital, Basel, Switzerland
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Ellison RT, Barysauskas CM, Rundensteiner EA, Wang D, Barton B. A Prospective Controlled Trial of an Electronic Hand Hygiene Reminder System. Open Forum Infect Dis 2015; 2:ofv121. [PMID: 26430698 PMCID: PMC4589647 DOI: 10.1093/ofid/ofv121] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 08/17/2015] [Indexed: 11/13/2022] Open
Abstract
Background. The use of electronic hand hygiene reminder systems has been proposed as an approach to improve hand hygiene compliance among healthcare workers, although information on efficacy is limited. We prospectively assessed whether hand hygiene activities among healthcare workers could be increased using an electronic hand hygiene monitoring and reminder system. Methods. A prospective controlled clinical trial was conducted in 2 medical intensive care units (ICUs) at an academic medical center with comparable patient populations, healthcare staff, and physical layout. Hand hygiene activity was monitored concurrently in both ICUs, and the reminder system was installed in the test ICU. The reminder system was tested during 3 administered phases including: room entry/exit chimes, display of real-time hand hygiene activity, and a combination of the 2. Results. In the test ICU, the mean number of hand hygiene events increased from 1538 per day at baseline to 1911 per day (24% increase) with the use of a combination of room entry/exit chimes, real-time displays of hand hygiene activity, and manager reports (P < .001); in addition, the ratio of hand hygiene to room entry/exit events also increased from 26.1% to 36.6% (40% increase, P < .001). The performance returned to baseline (1473 hand hygiene events per day) during the follow-up phase. There was no significant change in hand hygiene activity in the control ICU during the course of the trial. Conclusions. In an ICU setting, an electronic hand hygiene reminder system that provided real-time feedback on overall unit-wide hand hygiene performance significantly increased hand hygiene activity.
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Affiliation(s)
- Richard T Ellison
- Division of Infectious Diseases and Immunology, Department of Medicine
| | - Constance M Barysauskas
- Department of Quantitative Health Sciences , University of Massachusetts Medical School , Worcester ; Department of Biostatistics and Computational Biology , Dana-Farber Cancer Institute , Boston
| | - Elke A Rundensteiner
- Department of Computer Sciences , Worcester Polytechnic Institute , Massachusetts
| | - Di Wang
- Department of Computer Sciences , Worcester Polytechnic Institute , Massachusetts ; Microsoft Corporation , Redmond, Washington
| | - Bruce Barton
- Department of Quantitative Health Sciences , University of Massachusetts Medical School , Worcester
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Karaaslan A, Kepenekli Kadayifci E, Atıcı S, Sili U, Soysal A, Çulha G, Pekru Y, Bakır M. Compliance of healthcare workers with hand hygiene practices in neonatal and pediatric intensive care units: overt observation. Interdiscip Perspect Infect Dis 2014; 2014:306478. [PMID: 25525428 PMCID: PMC4262750 DOI: 10.1155/2014/306478] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 11/10/2014] [Indexed: 11/17/2022] Open
Abstract
Background. The objective of this study was to assess the compliance of hand hygiene (HH) of healthcare workers (HCWs) in the neonatal and pediatric intensive care unit in a tertiary university hospital in Istanbul. Methods. An observational study was conducted on the compliance of HH for the five World Health Organization (WHO) indications. HCWs were observed during routine patient care in day shift. The authors also measured the technique of HH through hand washing or hand hygiene with alcohol-based disinfectant. Results. A total of 704 HH opportunities were identified during the observation period. Overall compliance was 37.0% (261/704). Compliance differed by role: nurses (41.4%) and doctors (31.9%) [P = 0.02, OR: 1.504, CI 95%: 1.058-2.137]. HCWs were more likely to use soap and water (63.6%) compared to waterless-alcohol-based hand hygiene (36.3%) [P < 0.05]. Conclusion. Adherence to hand hygiene practice and use of alcohol-based disinfectant was found to be very low. Effective education programs that improve adherence to hand hygiene and use of disinfectants may be helpful to increase compliance.
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Affiliation(s)
- Ayşe Karaaslan
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Marmara University Medical Faculty, Istanbul, Turkey
| | - Eda Kepenekli Kadayifci
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Marmara University Medical Faculty, Istanbul, Turkey
| | - Serkan Atıcı
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Marmara University Medical Faculty, Istanbul, Turkey
| | - Uluhan Sili
- Department of Infectious Diseases, Marmara University Medical Faculty, Istanbul, Turkey
| | - Ahmet Soysal
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Marmara University Medical Faculty, Istanbul, Turkey
| | - Gülcan Çulha
- Infectious Control Nurses, Marmara University Medical Faculty, Istanbul, Turkey
| | - Yasemin Pekru
- Infectious Control Nurses, Marmara University Medical Faculty, Istanbul, Turkey
| | - Mustafa Bakır
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Marmara University Medical Faculty, Istanbul, Turkey
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13
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Scheithauer S, Häfner H, Schröder J, Nowicki K, Lemmen S. Influence of signal colored hand disinfectant dispensers on hand hygiene compliance at a medical intensive care unit. Am J Infect Control 2014; 42:926-8. [PMID: 25087148 DOI: 10.1016/j.ajic.2014.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 05/20/2014] [Accepted: 05/20/2014] [Indexed: 12/01/2022]
Abstract
To assess the influence of signal colors on hand disinfectant dispenser activities, health care workers (HCWs) at a medical intensive care unit were analyzed for a total of 20 weeks with 8 weeks before and 12 weeks after exchange to signal color. No significant increase in hand rubs (HRs) per patient day (PD) was observed (about 40 HRs/PD); however, HCW-adjusted compliance showed a 6% increase with signal colored devices. Therefore, colored devices may help to improve hand hygiene compliance.
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Affiliation(s)
- Simone Scheithauer
- Central Institute of Infection Control and Infectious Diseases, University Hospital Aachen, RWTH Aachen, Aachen, Germany; Central Institute of Infection Control and Infectious Diseases, University Medicine Göttingen, Göttingen, Germany.
| | - Helga Häfner
- Central Institute of Infection Control and Infectious Diseases, University Hospital Aachen, RWTH Aachen, Aachen, Germany
| | - Jörg Schröder
- Department of Medicine I, University Hospital Aachen, RWTH Aachen, Aachen, Germany
| | - Katharina Nowicki
- Central Institute of Infection Control and Infectious Diseases, University Hospital Aachen, RWTH Aachen, Aachen, Germany
| | - Sebastian Lemmen
- Central Institute of Infection Control and Infectious Diseases, University Hospital Aachen, RWTH Aachen, Aachen, Germany
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14
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Gholami Fesharaki M, Rahmati-najarkolaei F, Aghamiri Z, Mohamadian M. Hand-Washing Compliance Rate and the Influencing Factors. Arch Clin Infect Dis 2014; 9. [DOI: 10.5812/archcid.17316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ward MA, Schweizer ML, Polgreen PM, Gupta K, Reisinger HS, Perencevich EN. Automated and electronically assisted hand hygiene monitoring systems: a systematic review. Am J Infect Control 2014; 42:472-8. [PMID: 24773785 DOI: 10.1016/j.ajic.2014.01.002] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 12/31/2013] [Accepted: 01/06/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Hand hygiene is one of the most effective ways to prevent transmission of health care-associated infections. Electronic systems and tools are being developed to enhance hand hygiene compliance monitoring. Our systematic review assesses the existing evidence surrounding the adoption and accuracy of automated systems or electronically enhanced direct observations and also reviews the effectiveness of such systems in health care settings. METHODS We systematically reviewed PubMed for articles published between January 1, 2000, and March 31, 2013, containing the terms hand AND hygiene or hand AND disinfection or handwashing. Resulting articles were reviewed to determine if an electronic system was used. RESULTS We identified 42 articles for inclusion. Four types of systems were identified: electronically assisted/enhanced direct observation, video-monitored direct observation systems, electronic dispenser counters, and automated hand hygiene monitoring networks. Fewer than 20% of articles identified included calculations for efficiency or accuracy. CONCLUSIONS Limited data are currently available to recommend adoption of specific automatic or electronically assisted hand hygiene surveillance systems. Future studies should be undertaken that assess the accuracy, effectiveness, and cost-effectiveness of such systems. Given the restricted clinical and infection prevention budgets of most facilities, cost-effectiveness analysis of specific systems will be required before these systems are widely adopted.
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Affiliation(s)
- Melissa A Ward
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Marin L Schweizer
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA; Iowa City VA Health Care System, Iowa City, IA
| | - Philip M Polgreen
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Kalpana Gupta
- VA Boston Health Care System, West Roxbury, MA; Boston University School of Medicine, Jamaica Plain, MA
| | - Heather S Reisinger
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA; Iowa City VA Health Care System, Iowa City, IA
| | - Eli N Perencevich
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA; Iowa City VA Health Care System, Iowa City, IA.
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Duszak R, Lanier B, Tubbs JA, Ogilvie M, Thompson-Jaeger S. Bacterial Contamination of Radiologist Workstations: Results of a Pilot Study. J Am Coll Radiol 2014; 11:176-9. [DOI: 10.1016/j.jacr.2013.05.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 05/20/2013] [Indexed: 11/28/2022]
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Rothe C, Schlaich C, Thompson S. Healthcare-associated infections in sub-Saharan Africa. J Hosp Infect 2013; 85:257-67. [DOI: 10.1016/j.jhin.2013.09.008] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 09/01/2013] [Indexed: 11/18/2022]
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