Correlation of Hand Hygiene Compliance Measured by Direct Observation with Estimates Obtained from Product Usage

Branch‐Elliman, Westyn; King, Aleah D.; Baldini, Linda M.; Dooley, Kaitlyn; Yassa, David S.; Wright, Sharon B.

doi:10.1017/ice.2018.70

Cited by 5 publications

(5 citation statements)

References 9 publications

(21 reference statements)

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“…Direct observation is considered the gold standard for HH monitoring [ 1 ], but it is resource consuming and subject to considerable bias and limitations, as it requires observers to be present during all stages of patient care [ 23 , 24 , 25 ]. During the pandemic, the diversion of personnel to outbreak management and shortages of HCWs with appropriate IPC training have affected healthcare facilities’ ability to gather IPC data, including process measures such as HH compliance [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, we investigated whether alcohol-based handrub usage could be used as surrogate indicator for HH compliance in this context. This strategy has been evaluated in other settings, as data on product usage are relatively simple to obtain and no additional staff or other resources are required [ 25 ]. Further, this metric is not subject to the Hawthorne effect [ 15 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Hand Hygiene Practices during the COVID-19 Pandemic in Northern Italy: Assessment of Compliance Rates Measured by Direct Observation and Alcohol-Based Handrub Usage

Vicentini¹,

Libero²,

Bordino³

et al. 2022

Antibiotics

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Hand hygiene (HH) is among the most effective measures for reducing the transmission of healthcare-associated infections and SARS-CoV-2. We aimed to assess HH practices among healthcare workers (HCWs) of three hub hospitals in Northern Italy during the COVID-19 pandemic, by assessing HH compliance measured by direct observation and alcohol-based handrub usage. An observational study was conducted over a period of three months, between February and April 2021. HH compliance audits were conducted using the WHO My 5 Moments for HH approach. Multivariable logistic regression was used to evaluate independent predictors of HH compliance: ward type, HCW category and HH indication. Spearman correlation was used to investigate the relationship between HH compliance and alcohol-based handrub consumption. In total, 2880 HH opportunities were observed, with an overall compliance of 68%. Significant differences were found in compliance rates across ward types, HCW categories and HH indications. The mean alcohol-based handrub usage among included wards was 41.63 mL/PD. No correlation was identified between compliance rates and alcohol-based handrub consumption (ρ 0.023, p 0.943). This study provided a snapshot of HH practices in a pandemic context, which could be useful as a reference for future studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hand Hygiene Practices during the COVID-19 Pandemic in Northern Italy: Assessment of Compliance Rates Measured by Direct Observation and Alcohol-Based Handrub Usage

Vicentini¹,

Libero²,

Bordino³

et al. 2022

Antibiotics

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“…Since the HE is rooted in participants’ awareness that they are being observed, a covert observer has been the most commonly used method, resulting in variable success in minimising the HE 30 36 37. Other options for mitigating the HE include minimising the duration of observations,11 using participant observers,38 or using indirect outcomes, such as total soap utilisation 39 40…”

Section: Discussionmentioning

confidence: 99%

Out of sight, out of mind: a prospective observational study to estimate the duration of the Hawthorne effect on hand hygiene events

et al. 2020

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BackgroundHuman auditing has been the gold standard for evaluating hand hygiene (HH) compliance but is subject to the Hawthorne effect (HE), the change in subjects’ behaviour due to their awareness of being observed. For the first time, we used electronic HH monitoring to characterise the duration of the HE on HH events after human auditors have left the ward.MethodsObservations were prospectively conducted on two transplant wards at a tertiary centre between May 2018 and January 2019. HH events were measured using the electronic GOJO Smartlink Activity Monitoring System located throughout the ward. Non-covert human auditing was conducted in 1-hour intervals at random locations on both wards on varying days of the week. Two adjusted negative binomial regression models were fit in order to estimate an overall auditor effect and a graded auditor effect.ResultsIn total, 365 674 HH dispensing events were observed out of a possible 911 791 opportunities. In the adjusted model, the presence of an auditor increased electronic HH events by approximately 2.5-fold in the room closest to where the auditor was standing (9.86 events per hour/3.98 events per hour; p<0.01), an effect sustained across only the partial hour before and after the auditor was present but not beyond the first hour after the auditor left. This effect persisted but was attenuated in areas distal from the auditor (total ward events of 6.91*6.32–7.55, p<0.01). Additionally, there was significant variability in the magnitude of the HE based on temporal and geographic distribution of audits.ConclusionThe HE on HH events appears to last for a limited time on inpatient wards and is highly dynamic across time and auditor location. These findings further challenge the validity and value of human auditing and support the need for alternative and complementary monitoring methods.

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“…Standard infection prevention protocols on the HSCT unit prior to January 2012 included hand hygiene with alcohol-based hand rub or soap and water; hand hygiene monitoring via product usage measurement 10 validated with intermittent direct observation; cleaning of patient and common areas with quaternary ammonium-based disinfectants; and active screening and restriction of visitors with symptoms of viral infection. All patients with presumed norovirus are placed on contact precautions, and bleach cleaning daily and after discharge was and remains standard for patients with norovirus.…”

Section: Infection Control Measuresmentioning

confidence: 99%

Identification of a norovirus outbreak on a hematopoietic stem cell transplant unit and development and implementation of a novel infection prevention algorithm for controlling transmission

Branch‐Elliman

Araujo‐Castillo

Sullivan

et al. 2020

Infect. Control Hosp. Epidemiol.

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Correlation of Hand Hygiene Compliance Measured by Direct Observation with Estimates Obtained from Product Usage

Cited by 5 publications

References 9 publications

Hand Hygiene Practices during the COVID-19 Pandemic in Northern Italy: Assessment of Compliance Rates Measured by Direct Observation and Alcohol-Based Handrub Usage

Hand Hygiene Practices during the COVID-19 Pandemic in Northern Italy: Assessment of Compliance Rates Measured by Direct Observation and Alcohol-Based Handrub Usage

Out of sight, out of mind: a prospective observational study to estimate the duration of the Hawthorne effect on hand hygiene events

Identification of a norovirus outbreak on a hematopoietic stem cell transplant unit and development and implementation of a novel infection prevention algorithm for controlling transmission

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